Abstract:

Background: Laparoscopic cholecystectomy (LC) is the gold standard in the treatment of gallbladder diseases, especially cholelithiasis. Conversion to open sometimes is inevitable for the cholecystectomy to be completed safely. We aimed to describe the common indications, early outcomes and rate of conversion and identify factors associated with conversion among patients undergoing laparoscopic cholecystectomy at Bugando Medical Centre (BMC).

Methods: This was a retrospective and prospective cross-sectional study. Patients who underwent LC between April 2022 and December 2023 were studied retrospectively and those who underwent LC between January 2024 and April 2024 were studied prospectively. Data was analysed using STATA v15, and descriptive statistics were reported in tables and charts. Associations were subjected to X2 or Fischer’s exact for categorical variables. Patients with incomplete data were excluded from the study.

Results: Of the 117 patients who were included in the study, 102 (87.1%) were females and 15(12.9%) were males. The mean age ± SD was 44.8±15.2years. Symptomatic cholelithiasis was the most common indication for surgery in 104 (97.2 %) patients. The operation was completed laparoscopically in 102(87.2%) of the patients. Conversion to open cholecystectomy was in 15 (12.8%), adhesions were the most common reason for conversion (n=5, 35.7%). Out of 117 patients who underwent laparoscopic cholecystectomy, 111(94.9%) were treated successfully, and the remaining 6(5.1%) developed complications, of which bile duct injury and surgical site infection were the most common complication each having 1.7% of all participants. The rate of conversion was associated with co-morbidities (p = 0.001), Intraoperative complications (p< 0.001), sickle cell disease (p < 0.001) and acute cholecystitis (p = 0.016). The length of hospital stay was associated with conversion (p < 0.001. No patient died in this study.

Conclusion: Laparoscopic cholecystectomy is a safe in our setting .The rate of conversion was significantly high in patients with co-morbidities, intraoperative complications, sickle cell disease and acute cholecystitis.