Esra Adam
Introduction
Gallstone disease is a common surgical condition. Laparoscopic cholecystectomy is the gold-standard treatment; however, conversion to open surgery may be required due to intraoperative difficulties. Identifying predictors of conversion is important to improve surgical planning and outcomes.
Methods
A retrospective cross-sectional study was conducted at Muhimbili National Hospital, Tanzania. Medical records of 230 patients who underwent laparoscopic cholecystectomy between January 2022 and January 2024 were reviewed. Demographic, clinical, and intraoperative data were analysed using chi-square tests and logistic regression. A p-value <0.05 was considered significant.
Results
Among 230 patients, 77.8% were female, with a mean age of 47 years. The conversion rate was 9.2%. Cholelithiasis was the main indication (89.1%). Significant predictors of conversion included higher body weight (p=0.04), lower surgeon experience (p=0.02), and intraoperative findings such as inflammation and dense adhesions (p=0.001).
Conclusions
Conversion remains a challenge in the surgical practice. Higher patient weight, limited surgeon experience, and difficult intraoperative findings increase the risk of conversion. Early identification of high-risk patients may improve operative planning and outcomes.
Authors
Esra Hady, Muhimbili National Hospital
Dar Al Salam, Tanzania, United Republic of University of Medical Science and Technology, Khartoum, Sudan