Laparoscopic cholecystectomy is now popular due to its effectiveness and benefit of simple, minimally invasive technique with prompt recovery and shorter hospital stay. Although it can be successfully performed the majority of the time, there
remains a
significant number of patients who require conversion to open cholecystectomy.
To identifiy the factors predisposing to conversion. we retrospectively reviewed all patients undergoing laparoscopic cholecystectomy from April 1992 to April 1995 at the Pusan Paik Hospital Twenty nine(5%) of the 580 patients were converted to
open
cholecystectomy. Difficult dissection secondary to severe inflammation or dense adhesions was the most common reason for conversions. The risk ractors predisposing to conversion were non-visualization of gallbladder on oral cholecystogram,
emergency
operation, leukocytosis and abnormal liver function test by univariate analysis. Multivariate analysis found nonvisualization of gallbladder on oral cholecystogram, age over 65 years, acute cholecystitis and emergency operation. Of all these risk
factors, patients with non-visualization of gallbladder on oral cholecystogram were most likely to require conversion to open cholecystectomy.
It is hoped that this study will help to identifiy patients as high risk for conversion to open cholecystectomy, in the hope that laparoscopic cholecystectomy will be performed more safely with minimal morbidity by earlier recognition of the need
for
conversion.
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