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Difficult Laparoscopic Cholecystectomy: Timing for Conversion

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Difficult Acute Cholecystitis

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Abstract

Although laparoscopic cholecystectomy is the gold standard treatment for benign gallbladder disease, a number of conditions have been repetitively shown to be associated with an increased risk of conversion to the open approach. These include several disease-related and patient-related factors such as advanced age, severe acute cholecystitis, a history of multiple abdominal operations, and comorbidities. Although preoperative identification is crucial for proper patient selection and treatment algorithm, the verdict to convert is primarily deemed on the intraoperative surgeon decision as a safe “bailout” technique. This chapter aims to review the conditions that have been shown to consistently increase the risk of conversion, as well as highlight the importance of conversion as wise approach in the difficult cholecystectomy case where the risks of continuing with the laparoscopic cholecystectomy clearly outweigh the morbidity that comes with conversion to open.

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Authors and Affiliations

  1. Complex Surgical Oncology Research Fellow, Department of GI Surgical Oncology, University of Pittsburgh Medical Center, Pittsburgh, PA, USA

    Samer AlMasri

  2. Associate Professor of Clinical Surgery, Department of Surgery, American University of Beirut Medical Centre, Beirut, Lebanon

    Ali Hallal

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  1. Department of Medical, Surgical Sciences and Advanced Technologies, University of Catania, Catania, Italy

    Isidoro Di Carlo

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AlMasri, S., Hallal, A. (2021). Difficult Laparoscopic Cholecystectomy: Timing for Conversion. In: Di Carlo, I. (eds) Difficult Acute Cholecystitis. Springer, Cham. https://doi.org/10.1007/978-3-030-62102-5_9

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