SSK Bölge Hastanesi Genel Cerrahi Kliniği, Konya

Objective: To determine the number of laparoscopic cholecystectomy procedures, reasons and risk factors for conversion to open cholecystectomy, which were performed at Konya Hospital of Social Securities Institution. Methods: 4861 laparoscopic cholecystectomy procedures performed between 1995 and 2003 were analyzed. Patients' age and sex were noted. The causes of conversion to open cholecystectomy, the number of acute cholecystitis and chronic cholelithiasis cases, conversion rates according to the age groups were determined. Results: There were 3978 women (81.2%) and 883 men (18.2%). Median ages of women, men and general patient population were 47.9 years, 51.3 years and 48.5 years, respectively. Conversion to open cholecystectomy was needed in 244 (5%) patients. Causes of conversion were determined as fibrosis in Calot's triangle (n=80), acute cholecystitis (n=49), bleeding (n=26), stone in choledocus (n=13), adhesions due to previous operations (n=13), difficulty in dissection (n=12), organ injury (n=10), anatomical variation (n=9), suspected malign disease (n=6), technical problems (n=6), perforation of gallbladder and seeding of stones into abdominal cavity (n=4), other causes (n=16). Conclusion: Total conversion rate to open cholecystectomy was 5%. Most common causes of conversion were fibrosis in Calot's triangle, acute cholecystitis and bleeding. Risk factors of conversion to open cholecystectomy were determined as follows: male gender, being elderly and the diagnosis of acute cholecystitis before the operation.