Journal of Postgraduate Medicine
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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




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


How to cite this URL:
Bhattacharya K. Conversion from laparoscopic to open cholecystectomy. J Postgrad Med [serial online] 2005 [cited 2021 Dec 3 ];51:153-153
Available from: https://www.jpgmonline.com/text.asp?2005/51/2/153/16388


Full Text

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

1Tayeb 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.
2Nachnani J, Supe A. Pre -operative prediction of difficult laparoscopic cholecystectomy using clinical and ultrasonographic parameters. Indian J Gastroenterol 2005;24:16-8.
3Livingston EH, Rege RV. A nationwide study of conversion from laparoscopic cholecystectomy . Am J Surg 2004;188:205-11.
4Madan 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.
5Lunbosch JM, Druart ML, Puttemans T, Melot C. Guidelines to laparoscopic management of acute cholecystitis. Acta Chir Belg 2000;100:198-204.
6Rosen M, Brody F, Ponsky J. Predictive factors for conversion of laparoscopic cholecystectomy. Am J Surg 2002;184:254-8.

 
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