AN EXPERIENCE OF CONVERSIONS RATE OF LAPROSCOPIC CHOLECYSTECTOMY INTO OPEN CHOLECYSTECTOMY IN A TERTIARY CARE HOSPITAL OF BANNU
Objectives: To determine the rate of conversion of laparoscopic cholecystectomy into open cholecystectomy in Khalifa
Gul Nawaz Teaching Hospital Bannu.
Material and methods: This Prospective study was conducted in surgical department of Khalifa Gul Nawaz Teaching
Hospital/Bannu Medical College Bannu from Mar 2016 to Dec 2016. Relevant informations were recorded from questionnaire
prepared in accordance with the objectives of the study
Results. A total of 74 patients were included in the study. Out of total 59(79.73%) were females 15(20.27%) were males
with male to female ration of 3.8:1. The age range of the patients was from 18 to 67 years with mean age and Standard
deviation was 38+3 years. Mode of age presented for laproscopic cholecystectomy was 40 years. The conversion
rate was 5.4% in our study. The main causes for conversion were iatrogenic and non iatrogenic. Adhesion was the
commonest non iatrogenic cause that was noted in 4 patients (5.41%). Among the iatrogenic causes the frequency of
the various complications that led to open surgery were; CBD injury (2.70%), hemorrhage in (2.70%) cases and gut
injury (1.35%) cases. Due to adhesions two cases (2.70%) developed CBD injury as well as hemorrhage during the
procedure. One case (1.35%) resulted with small gut injury again due to adhesions. In one case the adhesions case
were so tough and fibrous that we decided to move to open surgery to avoid further associated injuries.
Conclusion: Laprsoscopic cholecystectectomy is gold standard for intervening gall stone diseases. The procedure
saves hospital stay and has patient benefit (cosmetic and reduced post op pain). Still in this study we observed that
adhesion is the main cause of conversion to open cholecystectomy as observing adhesions and moving forward with
Lap-Chole can result in associated injuries (like CBD injury, gut injury and hemorrhage).