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| Year : 2005 | Volume
: 51
| Issue : 2 | Page : 153 |
Conversion from laparoscopic to open cholecystectomy
Kaushik Bhattacharya
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
 Source of Support: None, Conflict of Interest: None  | Check |
PMID: 16006719 
How to cite this article:
Bhattacharya K. Conversion from laparoscopic to open cholecystectomy. J Postgrad Med 2005;51:153 |
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 | |  |
| 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.  |
| 2. | Nachnani J, Supe A. Pre -operative prediction of difficult laparoscopic cholecystectomy using clinical and ultrasonographic parameters. Indian J Gastroenterol 2005;24:16-8. |
| 3. | Livingston EH, Rege RV. A nationwide study of conversion from laparoscopic cholecystectomy . Am J Surg 2004;188:205-11. [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. |
| 5. | Lunbosch JM, Druart ML, Puttemans T, Melot C. Guidelines to laparoscopic management of acute cholecystitis. Acta Chir Belg 2000;100:198-204. |
| 6. | Rosen M, Brody F, Ponsky J. Predictive factors for conversion of laparoscopic cholecystectomy. Am J Surg 2002;184:254-8. [PUBMED] [FULLTEXT] |
| This article has been cited by | | 1 |
Evaluation of predictive factors for conversion of laparoscopic cholecystectomy |
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| Gabriel, R., Kumar, S., Shrestha, A. | | Kathmandu University Medical Journal. 2009; 7(25): 26-30 | | [Pubmed] | |
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