Aim: Laparoscopic cholecystectomy (LC) has become the gold standard of treatment of gall bladder disease, but conversion to open cholecystectomy is still inevitable certain cases. The  knowledge of the rate& impact  of the  causes for conversion could help  the  surgeon  during  preoperative assessment  &  inform  the  patients accordingly .In this  study we review the causes and rate  of conversion  to open from  laparoscopic cholecystectomy.

Method and Materials: A total no. of 50 patients who were primarily posted for laparoscopic cholecystectomy, subsequently got converted to open cholecystectomy for various reasons were taken into the study. At the end of the study  the  various  factors  were  assessed  for  the  strength  of  association  and  a scoring  system  was  formulated  for  prediction  of  conversion   from  LC to OC.

Observation: The conversion rate is 8.34% in this study. T he commonest   cause were dense adhesion (40%), and obscure anatomy at calot”s triangle (36%).Pre-operative high WBC count is also another cause leading to conversion. The no. of attacks with co-morbid conditions was also leads to conversion. This  study  includes  twelve  no. of parameters to   formulate a scoring system to predict   conversion from  laparoscopic  cholecystectomy to open  cholecystectomy.

Conclusion:  A composite  scoring  system was  formulated  comprising   detail  history,  USG findings, and  laboratory  values  along with  co-morbid  conditions  which when present   would help us  in   predicting  conversion  from  laparoscopic  to open  cholecystectomy  in  any  given  patient.

Keywords: Acute Cholecystitis, Gall bladder, Laparoscopic Cholecystectomy, Conversion, Open Cholecystectomy.

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Dr Y. Tejkumar

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