ABSTRACT

Aim:

To determine the number of laparoscopic cholecystectomy procedures, reasons and risk factors for conversion to open cholecystectomy, which were performed in the General Surgery Departmnent of our Hospital.

Materials and Methods:

568 laparoscopic cholecystectomy procedures performed between 2008-2013 were analyzed. Patients’ age andsex were noted. The causes of conversion to open cholecystectomy, the number of acute cholecytitis and chronic cholelithiasis cases, conversion rates according to the age groups were determined.

Results:

The sex distribution of the cases was 525 (92.4%) and 43 (7.6 %) male (F/M: 4.1). Median age was45.5 ± 12.7 years (range: 18-82), median operative time was 60.2 minutes (range: 17-200). Indications for surgery, were chronic cholecystitis in 525 (92.4 %), acute cholecystitis in 33 (4.4 %), and gall bladder polyps in 6 (1 %), a calculous cholecystitis in 2patient (% 0.35) were operated. Overall, conversion to open laparotomy was necessary in 20 patients (3.5%) Seven patients (1.2 %) required reoperation due to complications.There was no mortality. Median post operative hospital stay was1.6 days (8 hours- 28 days). Causes of conversion were determined as fibrosis in Calot’striangle (n=3), acute cholecystitis (n=33), stone in choledocus (n=2), adhesions due to previous operations (n=1), difficulty in dissection (n=2), organ injury (n=2), anatomical variation (n=1), perforation of gall bladder and seeding of Stones into abdominal cavity (n=1).

Conclusion:

Acute cholecystitis seems to be the main factorin creasing the ratio of conversion to open cholecystectomy. Risk factors of conversion to open cholecystectomy were determined as follows: male gender, being elderly and the diagnosis of acute cholecystitis before the operation. However, laparoscopic cholecystectomy should be the first choice for all cases with cholelithiasis