Laparoscopic cholecystectomy: the outcome with minimal conversion rate: experience in a district hospital.

Background: Since introducing laparoscopic cholecystectomy (LC) different centres have reported different conversion rate (CR) to open cholecystectomy (OC) and different reasons for conversion.

Objective: To evaluate the role of LC in the treatment of symptomatic gallstones and establish the outcomes of this treatment modality in general, looking especially into the rate of conversion to OC, at a district hospital.

Methods: From July 1992-July 1998, 751 patients who underwent LC were retrospectively reviewed. All patients with symptomatic gallstones were offered LC with no exclusion criteria apart from anaesthetic opinion. No attempts were made at selection of patients for LC.

Results: There were 751 patients with symptomatic gallstones (617 females, 134 males) underwent LC. Chronic cholecystitis represented the majority of cases (83%). The mean operative time was 65.52 minutes: pre-operation and main hospital stay was 2.46 days. Our total conversion rate was 0.9% and 0.4% if malignancy of the gallbladder is excluded. In comparison to the published data, there was obvious lower conversion rate, which was neither associated with increased morbidity nor mortality.

Conclusions: Laparoscopic cholecystectomy is a reliable, safe and cost effective treatment modality for symptomatic gallstones. With growing experience in laparoscopic technique, proper settings and harmony of the operating team, it is possible to bring the conversion rate to OC to the minimum without any increment in mortality or morbidity.