Pre-operative Status as a Deciding Tool in Predicting Failure of Laparoscopic Cholecystectomy in Acute Calculous Cholecystitis
Introduction: Laparoscopic cholecystectomy is the most commonly done procedure for gall stone disease. However few cases
of acute calculous cholecystitis require conversion to open procedure which can increase the morbidity and financial burden to
patient. Hence, through this study we are trying to use certain preoperative factors which can predict the chances of failure of
laparoscopic procedure in acute calculous cholecystitis patient and thus prevent unnecessary trail of laparoscopy in such patients.
Aims and Objectives: To assess the symptoms in patient to predict conversion of laparoscopic cholecystectomy to open
cholecystectomy in patients with acute calculous cholecystitis. To identify preoperative parameters to predict conversion of
laparoscopic cholecystectomy to open cholecystectomy in patients with acute calculous cholecystitis. To correlate the preoperative
factors with intraoperative severity.
Materials and Methods: A prospective study was conducted in Bangalore medical college, Bengaluru from May 2019 to November
2020 on 100 patients with diagnosed acute calculous cholecystitis.
Results: 100 patients of acute calculous cholecystitis underwent trial of laparoscopic cholecystectomy of which 16 patients had
to undergo conversion to open procedure whereas remaining 84 patients underwent successful laparoscopic cholecystectomy.
Conclusion: In our study male gender, elderly age, raised serum alkaline phosphatse, raised total bilirubin, raised total leucocyte
count were associated with higher chances conversion to open procedure and hence was concluded that these patients were
poor candidates for laparoscopic cholecystectomy.