Indian Journal of Surgery
Medknow Publications on behalf of Association of Surgeons of India
Vol. 68, No. 4, 2006, pp. 205-208
Bioline Code: is06059
Full paper language: English
Document type: Research Article
Document available free of charge
Indian Journal of Surgery, Vol. 68, No. 4, 2006, pp. 205-208
© Copyright 2006 Indian Journal of Surgery.
Difficult laparoscopic cholecystectomy: A large series from north India|
Singh Kuldip, Ohri Ashish
Background: Laparoscopic cholecystectomy (LC) has become the gold standard for gallstone disease. We present one of the largest series of LC from the high prevalence area of gallstone disease.
Aim: To analyze the single-center experience with respect to conversion rate and complication rate.
Settings and Design: Retrospective observational study.
Materials and Methods : Data of all the patients who were operated between May 1992 and July 2005 was collected retrospectively and difficult cases were identified out of them based on the intraoperative pathology. These cases were analyzed in relation to conversion to open surgery and complication rate.
Results : LC was performed in 6,380 patients at our center. Based on the criteria selected on the intraoperative pathology, 1,446 (22.66%) cases were identified as difficult cases. Laparoscopy had to be abandoned and the procedure was converted to conventional surgery in 27 patients with a conversion rate of 1.86% (n=27) of the difficult cases and 0.42% (n=27) of the total LCs done. All the conversions were in the difficult group. The most common intraoperative complication was bile duct injury (n=14) (0.96%), which led to four conversions.
Conclusions : From our experience, we emphasize that the experience of the surgeon and meticulous surgical technique are the most important factors to achieve a low complication rate.
Laparoscopic cholecystectomy, complication, conversion