A. Hellberg et al., Conversion from laparoscopic to open appendicectomy: A possible drawback of the laparoscopic technique?, EURO J SURG, 167(3), 2001, pp. 209-213
Objective: To analyse the reasons for, and outcome of, conversion from lapa
roscopic to open appendicectomy and to identify factors that may predict th
e need for conversion.
Design: Subgroup analysis from a randomised multicentre study.
Setting: One university hospital and four county hospitals, Sweden. Subject
s: A total of 500 patients were randomised to laparoscopic (n = 244) or ope
n (n = 256) appendicectomy. Thirty operations (12%) were converted to open
appendicectomy.
Main outcome measures: Reasons for conversion, outcome, and preoperative pr
edictive variables.
Results: Difficult anatomy or the presence of an abscess were the main reas
ons for conversion (25/30). The incidence of perforated appendicitis was hi
gher among patients who required conversion compared with both the open and
laparoscopic group. Operating time, anaesthetic time, and duration of hosp
ital stay were longer after conversion. Time to full recovery and length of
sick leave were also longer, except for patients with perforated appendici
tis. There was no difference in the complication rate. No predictive factor
s were identified.
Conclusion: The main reasons for conversion were difficult anatomy and the
presence of an abscess. After conversion patients recovered more slowly tha
n those operated on laparoscopically or by primary open operation.