Rate of Conversion from Laparoscopic to open Cholecystectomy at PUMHS Nawabshah

Abstract

Objective: To determine the conversion rate in laparoscopic cholecystectomy at PUMI-IS Nawabshah. Study Design: Cross sectional Descriptive study. Place & Duration: Surgical Unit I, Peoples University of Medical and Health Sciences Nawabshah, from February 2013 to December 2015. Material & Methods: 196 symptomatic patients with gall stones diseases underwent laparoscopic cholecystectomy. Data was analyzed for age, sex, reasons and rate of conversion from Laparoscopic cholecystectomy to open cholecystectomy, post operative pain, post operative hospital stay and days required to work. SPSS-24 (statistical package for social sciences) was used for statistical analysis. Results: A total of 196 patients were included in this study that underwent laparoscopic cholecystectomy, out of them 22 were male and 174 were female making a ratio of 1:8. Mean age of the patients was 39.4years. SD+11.4 and a range of (13-75). More patients (36%) belonged to 4th decade while least no 0.5% of patients belonged to 8th decade, Out of 196 patients who underwent laparoscopic cholecystectomy, 15 patients (7.6%) needed to be converted to open cholecystectomy. Conversion rate was 12% in first 100 cases while it was decreased to 3.6'Y° in next 96 cases making a cumulative conversion rate of 7.6%. Most common reason of conversion was found as dense adhesions 53% making calot's triangle unclear where as other less common reasons were empyma gall bladder 13.3%, CBD injury 6.60. , perforated gall bladder 13%, intestinal injury 6% and dilated CBD with choledocholithiasis in 7%. Mean post operative hospital stay was 56 hours, SD+ 29 and range (24-262). Post operatively time required to return to work, the mean value was 8.5 days, SD+ 2 and range (6 to 28). Conclusion: In PUMHS during the study period the conversion from laparoscopic cholecystectomy to open cholecystectomy was found at a rate of 7.6a /a with strong reflection oflearning curve.