अमूर्त

Single surgeon experience: intraoperative complications and conversion to open surgery in laparoscopic cholecystectomy, the fore and aft of 20 years' experience

Gokhan Demiral, Fikret Aksoy

Background: With the increasing experience of surgeons, there has been a decrease in the conversion rates from Laparoscopic Cholecystectomy (LC) to Open Cholecystectomy (OC). We aimed to investigate the experience of single surgeon in the decrease of conversion and complication rates related with gall bladder disease by examining data from the first and last 5 y of 20 y experiences.

Material and Methods: The data of 848 patients with cholelithiasis who underwent LC by the same surgeon in the first and last 5 y of a 20 y period from 1996-2016 were evaluated and compared. The first 5 y (1996-2001) was named as period 1 (n=418) and the last 5 y (2011-2016) were named as period 2 (n=430). Demographic data and conversion reasons were recorded.

Results: Period 1 consisted of 418 patients (380 females, 38 males) and period 2 comprised 430 patients (350 females, 80 males). The mean age was 45.2 y (20-84 y). Unclear obscure anatomy more prominently affected the conversion to OC in males in both periods (p=0.002 and p=0.043). Statistical significance was found in period 1 for male sex (p=0.019). The rate of males was detected higher in period 2 (p=0.001). Conversion to OC was 38 patients (9.1%) in period 1 and 20 patients (4.7%) in period 2.

Conclusion: Surgical experience is associated with lower conversion rates from LC to OC. Also many male patients are being operated on experienced phase.