Risk Factors for Converting from Laparoscopic to Open Cholecystectomy Procedures
Keywords:
Open cholecystectomy, Laparoscopic cholecystectomy, conversion, risk factors, gallbladder disease, intraoperative complications, obesity, prior abdominal surgery, hospital stay, operative timeAbstract
Background: For symptomatic gallstones, laparoscopic cholecystectomy (LC) has emerged as the preferred treatment; nevertheless, conversion to open cholecystectomy (OC) is still an option. Unfortunately, it's unknown whether preoperative indicators indicate conversion risk.
Methods: The records of 64 patients who underwent cholecystectomy from March 2023 to September 2024 were reviewed retrospectively. The demographics and preoperative data of patients who required conversion to laparotomy were compared to those with successful laparoscopic cholecystectomy.
Results: Around 62.5%, a significant conversion rate was noted. Male advanced age (>50 years), obesity, previous abdominal surgery, high leukocyte counts, and hyperglycemia were all significant risk factors for conversion. The main causes of conversion were intraoperative difficulties such thick adhesions, blurred anatomy, and impaired vision. Longer hospital stays, longer operating times, and more treatment expenses were experienced by patients undergoing conversion.
Conclusions: Patient demographics, comorbidities, and intraoperative findings all play a role in the multifactorial decision to convert from LC to OC. Preoperatively identifying high-risk patients can help with better planning, minimize unanticipated conversions, and guarantee optimal resource allocation during surgery. Conversion should not be viewed as a failure but rather as a safety measure to ensure better outcomes.
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References
Wongworawat, M. D., Aitken, D. R., Robles, A. E., and Garberoglio, C. The impact of prior intra-abdominal surgery on laparoscopic cholecystectomy. Am. Surg. 60: 763, 1994.
Sanabria, J. R., Gallinger, S., Croxford, R., and Strasberg, S. M. Risk factors in elective laparoscopic cholecystectomy for conversion to open cholecystectomy. J. Am. Coll. Surg. 179: 696, 1994.
Alponat, A., Kum, C. K., Bee, C. K., Rajnakova, A., and Goh, P. M. Y. Predictive factors for conversion of laparoscopic cholecystectomy. World J. Surg. 21: 629, 1997.
Lujan, J. A., Parrilla, P., Robles, R., Marin, P., Torralba, J. A and Garcia-Ayllon, J. Laparoscopic cholecystectomy vs open cholecystectomy in the treatment of acute cholecystitis. Arch. Surg. 133: 173, 1998.
Schrenk, P., Woisetschlager, R., and Wayand, W. U. Laparoscopic cholecystectomy. Surg. Endosc. 9: 25, 1995.
Wiebe, E. A., Pruitt, A. L., Howard, T. J., Jacobson, L. E., Broadie, T. A., Goulet, Jr., R. J., and Canal, D. F. Conversion of laparoscopic to open cholecystectomy. Surg. Endosc. 10: 742, 1996.
Domínguez LC, Rivera A, Bermúdez C, Herrera W. Analysis of factors for conversion of laparoscopic to open cholecystectomy: a prospective study of 703 patients with acute cholecystitis. Cir Esp. 2011;89(5):300-6.
Morales-Maza J, Rodríguez-Quintero J, Santes O, Aguilar-Frasco J, Romero-Vélez G, García-Ramos E, et al. Conversion from laparoscopic to open cholecystectomy: Risk factor analysis based on clinical, laboratory, and ultrasound parameters. Rev Gastroenterol Mex. 2020.
Magnano San Lio R, Barchitta M, Maugeri A, Quartarone S, Basile G, Agodi A. Preoperative Risk Factors for Conversion from Laparoscopic to Open Cholecystectomy: A Systematic Review and Meta-Analysis. Int J Environ Res Public Health. 2022;20.
Zhen-y W. Analysis on factors of conversion that laparoscopic cholecystectomy to open operation. 2012.
Sunny D, Luthra A, Mittal A, Vikramaditya D. Factors Influencing Conversion of Laparoscopic Cholecystectomy to Open Cholecystectomy. 2021.
Reddy SR, Balamaddaiah G. Predictive factors for conversion of laparoscopic cholecystectomy to open cholecystectomy: a retrospective study. Int Surg J. 2016; 3:817-20
Nasar MA, Talukdar R, Raj K, Agarwal P, Aditya, Some S, et al. Pre- Operative and Intra-Operative Factors for Conversion of Laparoscopic Cholecystectomy to Open Choleystectomy. SAS J Surg. 2021.
Hanson-Viana E, Ayala-Moreno EA, Ortega-Leon LH, Montalvo-Javé E. The Association of Preoperative Risk Factors for Laparoscopic Conversion to Open Surgery in Elective Cholecystectomy. Euroasian J Hepato-Gastroenterol. 2022;12(1):6-9
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