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LETTERS
Year : 2005  |  Volume : 51  |  Issue : 2  |  Page : 153

Conversion from laparoscopic to open cholecystectomy


Department of Surgery, Subham Hospital and Diagnostic Centre, Cooch Behar - 736101, West Bengal, India

Correspondence Address:
Kaushik Bhattacharya
Department of Surgery, Subham Hospital and Diagnostic Centre, Cooch Behar - 736101, West Bengal
India
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Source of Support: None, Conflict of Interest: None


PMID: 16006719

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How to cite this article:
Bhattacharya K. Conversion from laparoscopic to open cholecystectomy. J Postgrad Med 2005;51:153

How to cite this URL:
Bhattacharya K. Conversion from laparoscopic to open cholecystectomy. J Postgrad Med [serial online] 2005 [cited 2019 Oct 16];51:153. Available from: http://www.jpgmonline.com/text.asp?2005/51/2/153/16388


Sir,

I read the article by Tayeb et al[1] with interest. Even though the authors have identified the majority of risk factors for conversion to open cholecystectomy, I don't know why the sex of the patient was not considered. Male gender has been a significant risk factor for a high conversion rate in majority of the studies.[2],[3] Another factor is the time of surgery from the onset of symptoms. Patients undergoing intervention within 48 hours of the onset of symptoms experience a lower conversion rate to an open procedure.[4] A study from Belgium highlighted that preoperative C reactive protein seric level less than 10 mg% represent the best candidates for laparoscopic surgery.[5] In another study, the American Society of Anaesthesiologist (ASA) class of more than 2 also predicted conversions in patients undergoing non-elective cholecystectomies.[6] Finally, no matter how much preoperative risk grading or a diagnostic score is done to predict difficult laparoscopic cholecystectomy, the experience of the surgeon is the foremost factor. There should always be a low threshold of conversion whenever he faces any difficulty irrespective of the preoperative predictability.



 
 :: References Top

1.Tayeb M, Ahsan RS, Khan MR, Azami R. Conversion from laparoscopic to open cholecystectomy : Multivariate analysis of preoperative risk factors. J Postgrad Med 2005;51:17-20.  Back to cited text no. 1    
2.Nachnani J, Supe A. Pre -operative prediction of difficult laparoscopic cholecystectomy using clinical and ultrasonographic parameters. Indian J Gastroenterol 2005;24:16-8.  Back to cited text no. 2    
3.Livingston EH, Rege RV. A nationwide study of conversion from laparoscopic cholecystectomy . Am J Surg 2004;188:205-11.  Back to cited text no. 3  [PUBMED]  [FULLTEXT]
4.Madan AK, Aliabadi- Wahle S, Tesi D, Flint LM, Steinberg SM. How early is early laparoscopic treatment for acute cholecystitis ?. Am J Surg 2002;183:232-6.  Back to cited text no. 4    
5.Lunbosch JM, Druart ML, Puttemans T, Melot C. Guidelines to laparoscopic management of acute cholecystitis. Acta Chir Belg 2000;100:198-204.  Back to cited text no. 5    
6.Rosen M, Brody F, Ponsky J. Predictive factors for conversion of laparoscopic cholecystectomy. Am J Surg 2002;184:254-8.   Back to cited text no. 6  [PUBMED]  [FULLTEXT]



This article has been cited by
1 Evaluation of predictive factors for conversion of laparoscopic cholecystectomy
Gabriel, R., Kumar, S., Shrestha, A.
Kathmandu University Medical Journal. 2009; 7(25): 26-30
[Pubmed]



 

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Online since 12th February '04
2004 - Journal of Postgraduate Medicine
Official Publication of the Staff Society of the Seth GS Medical College and KEM Hospital, Mumbai, India
Published by Wolters Kluwer - Medknow