U Ates, G Gollu, E Ergun, B Turedi, F Mammadov, M Bingol-Kologlu, A Yagmurlu, T Aktug, H Dindar, AM Cakmak

Abstract

Introduction: The aim of this study is to evaluate and analyse the reasons for conversion to open surgery in laparoscopic cases in childhood, compared to the adult literature and differentiate the preventive measures for decreasing the rates for conversions. Patients and methods: The charts of 2068 patients who had appendectomy, Nissen fundoplication, cholecystectomy and splenectomy operations between 2003-2015 were reviewed retrospectively. Laparoscopic and open procedures and the cases that were converted from laparoscopy to open surgery and the reasons of conversions were analysed. Results: Between the years of 2003-2015, total of 2068 cases; appendectomy (1539), cholecystectomy (120), Nissen fundoplication (323) and splenectomy (86) operations were performed. Among these procedures, 181 (8.8%) of them were performed by laparotomy, 1887 (91.2%) of them were intended to be performed by laparoscopy. Among laparoscopically started cases, 1848 (97.9%) of them were completed laparoscopically and in 39 cases (2.1%) conversions were required. The conversion rates were 0.34%, 9.7%, 2.8% and 7.4% in appendectomy, Nissen fundoplication, cholecystectomy and splenectomy, respectively. Conclusion: Preoperative detailed and specific examinations before laparoscopic procedures can decrease the conversion rates in laparoscopic surgery. Complications do not have to be the only conversion indication and elective conversion must be performed without wasting time to avoid complications.