Laparoscopic Cholecystectomy; It’s Complications and Causes of Conversion to Open Cholecystectomy.
Background: The laparoscopic cholecystectomy is the gold standard for treating the symptomatic cholelithiasis. Conversion is sometimes necessary due to finding unexpected pathology,intraoperative complications or unexpected technical errors . Objectives: The aims of this study were to determine t...
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| Format: | Article |
| Language: | English |
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College of Medicine University of Baghdad
2014-01-01
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| Series: | مجلة كلية الطب |
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| Online Access: | http://iqjmc.uobaghdad.edu.iq/index.php/19JFacMedBaghdad36/article/view/567 |
| _version_ | 1797331281920393216 |
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| author | Jawad K. Al-Dhahiry |
| author_facet | Jawad K. Al-Dhahiry |
| author_sort | Jawad K. Al-Dhahiry |
| collection | DOAJ |
| description | Background: The laparoscopic cholecystectomy is the gold standard for treating the symptomatic cholelithiasis. Conversion is sometimes necessary due to finding unexpected pathology,intraoperative complications or unexpected technical errors .
Objectives: The aims of this study were to determine the complications and the predictive factors of conversion in patients undergoing laparoscopic cholecystectomy for various indications in elective and acute settings in a general hospital in order to reduce the incidence rates of both , complications and conversion of laparoscopic cholecystectomy to the open technique .
Patients and Methods: This is a prospective study included 128 patients [their ages ranged from18 -65 years; the mean =39.60 ± 11.37 SD years].Female patients were 111 (86.7 ) ,male patients were 17 (13.3 % ) . These patients underwent a laparoscopic cholecystectomy in AL-Karama Teaching Hospital / College of Medicine / Wasit University-Iraq,from April 2011 till December 2012. Recorded data were sex, age, indications for laparoscopic cholecystectomy , complications, conversion to the open technique , reasons of conversion, co- morbidity , length of the hospital stay and 30- day mortality.
Results: The intraoperative complications were; bleeding from the cystic artery in 9 patients (7.03 %), perforation of the gallbladders in17 patients (13.28% ) and spillage of the stones from cystic duct stump in12 patients( 9.37% ).All these complications were successfully treated laparoscopically.This study has no postoperative complications during follow-up period . Conversion from a laparoscopic cholecystectomy to an open cholecystectomy was performed for 7 patients ( 5.49 % ). The reasons for conversion were ; dense fibrosis of Calot’s triangle in two patients ( 1.56 % ) and one patient(0.78 % ) for each of the following pathologies : cholecystoduodental fistula ,postoperative adhesions , impacted stone in the cystic duct , Mirrizzi’s syndrome and incidental CBD stone.The intaoperative findings and postoperative histopathologic diagnoses were: 114 patients( 89.1 % ) with chronic calculous cholecystitis, 5 patients ( 3.9 % ) with acute calculous cholecystitis, 5 patients( 3,9 % ) with empyema of the gall bladder, 4 patients ( 3.1 % ) with mucocele of the gall bladder .There was no mortality in this study .
Conclusions: In this study,there were simple complications being laparoscopically treated .Male gender, age older than 50 years that were associated with dense fibrosis of Calot’s triangle , postoperative upper abdominal adhesions,cholecystoduodenal fistula Mirrizi’syndrome ,impaced stones in the cystic duct and incidental CBD stone were the main factors of conversion . |
| first_indexed | 2024-03-08T07:32:11Z |
| format | Article |
| id | doaj.art-8a335fa47f8b43169fed7066f10e561d |
| institution | Directory Open Access Journal |
| issn | 0041-9419 2410-8057 |
| language | English |
| last_indexed | 2024-03-08T07:32:11Z |
| publishDate | 2014-01-01 |
| publisher | College of Medicine University of Baghdad |
| record_format | Article |
| series | مجلة كلية الطب |
| spelling | doaj.art-8a335fa47f8b43169fed7066f10e561d2024-02-02T20:11:44ZengCollege of Medicine University of Baghdadمجلة كلية الطب0041-94192410-80572014-01-0155410.32007/jfacmedbagdad.v4296-301%Laparoscopic Cholecystectomy; It’s Complications and Causes of Conversion to Open Cholecystectomy.Jawad K. Al-Dhahiry0Dept. of surgery ,Medical College /Wasit University-IraqBackground: The laparoscopic cholecystectomy is the gold standard for treating the symptomatic cholelithiasis. Conversion is sometimes necessary due to finding unexpected pathology,intraoperative complications or unexpected technical errors . Objectives: The aims of this study were to determine the complications and the predictive factors of conversion in patients undergoing laparoscopic cholecystectomy for various indications in elective and acute settings in a general hospital in order to reduce the incidence rates of both , complications and conversion of laparoscopic cholecystectomy to the open technique . Patients and Methods: This is a prospective study included 128 patients [their ages ranged from18 -65 years; the mean =39.60 ± 11.37 SD years].Female patients were 111 (86.7 ) ,male patients were 17 (13.3 % ) . These patients underwent a laparoscopic cholecystectomy in AL-Karama Teaching Hospital / College of Medicine / Wasit University-Iraq,from April 2011 till December 2012. Recorded data were sex, age, indications for laparoscopic cholecystectomy , complications, conversion to the open technique , reasons of conversion, co- morbidity , length of the hospital stay and 30- day mortality. Results: The intraoperative complications were; bleeding from the cystic artery in 9 patients (7.03 %), perforation of the gallbladders in17 patients (13.28% ) and spillage of the stones from cystic duct stump in12 patients( 9.37% ).All these complications were successfully treated laparoscopically.This study has no postoperative complications during follow-up period . Conversion from a laparoscopic cholecystectomy to an open cholecystectomy was performed for 7 patients ( 5.49 % ). The reasons for conversion were ; dense fibrosis of Calot’s triangle in two patients ( 1.56 % ) and one patient(0.78 % ) for each of the following pathologies : cholecystoduodental fistula ,postoperative adhesions , impacted stone in the cystic duct , Mirrizzi’s syndrome and incidental CBD stone.The intaoperative findings and postoperative histopathologic diagnoses were: 114 patients( 89.1 % ) with chronic calculous cholecystitis, 5 patients ( 3.9 % ) with acute calculous cholecystitis, 5 patients( 3,9 % ) with empyema of the gall bladder, 4 patients ( 3.1 % ) with mucocele of the gall bladder .There was no mortality in this study . Conclusions: In this study,there were simple complications being laparoscopically treated .Male gender, age older than 50 years that were associated with dense fibrosis of Calot’s triangle , postoperative upper abdominal adhesions,cholecystoduodenal fistula Mirrizi’syndrome ,impaced stones in the cystic duct and incidental CBD stone were the main factors of conversion .http://iqjmc.uobaghdad.edu.iq/index.php/19JFacMedBaghdad36/article/view/567Laparoscopic Cholecystectomy, Cholecystitis, Cholelithiasis . |
| spellingShingle | Jawad K. Al-Dhahiry Laparoscopic Cholecystectomy; It’s Complications and Causes of Conversion to Open Cholecystectomy. مجلة كلية الطب Laparoscopic Cholecystectomy, Cholecystitis, Cholelithiasis . |
| title | Laparoscopic Cholecystectomy; It’s Complications and Causes of Conversion to Open Cholecystectomy. |
| title_full | Laparoscopic Cholecystectomy; It’s Complications and Causes of Conversion to Open Cholecystectomy. |
| title_fullStr | Laparoscopic Cholecystectomy; It’s Complications and Causes of Conversion to Open Cholecystectomy. |
| title_full_unstemmed | Laparoscopic Cholecystectomy; It’s Complications and Causes of Conversion to Open Cholecystectomy. |
| title_short | Laparoscopic Cholecystectomy; It’s Complications and Causes of Conversion to Open Cholecystectomy. |
| title_sort | laparoscopic cholecystectomy it s complications and causes of conversion to open cholecystectomy |
| topic | Laparoscopic Cholecystectomy, Cholecystitis, Cholelithiasis . |
| url | http://iqjmc.uobaghdad.edu.iq/index.php/19JFacMedBaghdad36/article/view/567 |
| work_keys_str_mv | AT jawadkaldhahiry laparoscopiccholecystectomyitscomplicationsandcausesofconversiontoopencholecystectomy |