Clinical analysis of immediate laparotomy secondart to laparoscopic cholecystectomy

Objective To explore and discuss the causes of conversion of laparoscopic cholecystectomy to open cholecystectomy.To evaluate the degree of operative difficulty and how to decrease the incidence of complications after LC.Methods We retrospectively reviewed 576 cases of LC,46 of which underwent an immediate conversion to open surgery.Causes of conversions,surgical techniques,and curative outcomes were analyzed.The clinical data revealed a bile duct injury in 3 cases,bleeding in 2 case,severe adhesion in abdominal cavity or between the gallbladder and neighboring tissues in 19 cases disturbed anatomy and adhesion in the region of the Calot's triangle in 14 cases,cholecystoduodenal fistula in 2 cases,and Mirizzi syndrome(type II) in 5 cases.Gastrointestinal injury in 1 case.Results The conversion to open surgery was successfully completed in all the 25 cases.No complication was encountered follow-up examinations for 1-2 years showed no bilc duct stenosis.Conclusion Proper preoperative patient selection and use of intraoperative preventive measures are helpful to minimize the possibility of conversion to open surgery.