DOI: 10.36347/sasjs.2021.v07i02.011

Pages: 73-77

Laparoscopic cholecystectomy is the gold standard treatment for gall stone disease. The advantages of laparoscopy over open has been documented in multiple studies with an increase patient acceptability due to less pain and early return to work. However, certain factors have been documented in predicting difficult laparoscopic cholecystectomy. In our institution, which is a tertiary care center in a rural community, we conducted a study on 280 consecutive patients fitting the inclusion criteria to determine the various pre-operative and intra-operative factors for conversion to open cholecystectomy from standard 4 port laparoscopic cholecystectomy. We observed a conversion rate of 6.05% with dense adhesion being the major cause of conversion. Various conversion rate have been reported in literatures ranging from 1.6%-19% [1, 2]. Other causes for conversion in the 17 patients being frozen Calots, Mirizzi’s syndrome, slippage of ligaclip, pre-operative factors like ERCP and 4.5 mm thickness of the gallbladder.