Journal of AdvancedMedical and Dental Sciences Research

Background: Gallstones are a common gastrointestinal issue that often requires hospitalization. The preferred surgical method for most patients is laparoscopic cholecystectomy. However, in some cases, the procedure needs to be converted to an open cholecystectomy due to factors like adhesions, complex anatomy at Calot's triangle, or common bile duct injury. This study was conducted in the surgery department of a tertiary care center, with the primary goal of identifying the factors that lead to the conversion from laparoscopic to open cholecystectomy. The secondary objectives included examining the age, gender, and underlying causes of cholelithiasis. Methods: In this prospective observational study, a total of 100 patients were enrolled after obtaining informed consent and receiving ethical clearance from the Institutional Review and Research Committee (IRRC). Patients who had been diagnosed with cholelithiasis through various imaging techniques such as ultrasonography (USG), magnetic resonance cholangiopancreatography (MRCP), and endoscopic retrograde cholangiopancreatography (ERCP) were scheduled for laparoscopic cholecystectomy. Results: Out of the 100 patients enrolled in this study, 9 of them required conversion from laparoscopic cholecystectomy to an open procedure. The leading cause for conversion was the presence of adhesions, which accounted for the majority at 8%. Other factors contributing to the need for conversion included common bile duct (CBD) injury (2%), bleeding of the cystic artery (2%), bowel injury (1%), and unclear anatomy (3%). Conclusion: Laparoscopic cholecystectomy is generally considered a safe and minimally invasive procedure with a low conversion rate. However, this study highlighted that the primary reason for conversion to open cholecystectomy was the presence of dense adhesions in Calot's triangle. This underscores the significance of adhesions as a common factor leading to the need for switching from laparoscopic to open cholecystectomy.