A five years analysis of laparoscopic cholecystectomy conversion, when and why ?

Abstract EN

Contraindications to laparoscopic cholecystectomy diminished over the last decade but still conversion rate is about 5-6 % in elective cases and higher in acute cholecystitis.

The aim of this study is to analyze the reasons for conversion in all patients laparoscopically operated on for cholecystectomy in our surgical department and to create strategies for critical moments when conversion needed.

From 2005 to 2010, the data sheets of all patients subjected for laparoscopic cholecystectomy had been analyzed regarding sex, age, intraoperative finding, the time and reason for conversion.

Of the 899 patients who underwent laparoscopy cholecystectomy (83 male and 816 female), 3.8 % [34 patients (21 women, 2.5 % and 13 men, 15.61 %)] were converted to open cholecystectomy.

Difficulties with the anatomy in Calot's triangle (58.8 %), difficulties in establishing pneumoperitoneum (8.8 %) and bleeding (8.8 %) have been the main reasons for conversion.

In conclusion, the scene keys for conversion are difficulties in Calot's triangle, intra-abdominal adhesions, and the creation of the pneumoperitoneum.

Conversion should not be regarded as a complication.