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Early conversion for gangrenous cholecystitis: impact on outcome
J Bingener1, D Stefanidis, M L Richards
1Department of Surgery, University of Texas Health Science Center, MC7842, San Antonio, TX 78229, USA. bingenercas@uthscsa.edu
Surgical Endoscopy
|July 16, 2005
Summary
Early conversion to open surgery for gangrenous cholecystitis did not increase patient morbidity. While hospital stays were longer, operative times were shorter, suggesting benefits despite a moderate risk of conversion.
Area of Science:
- Surgical Innovation
- Minimally Invasive Surgery
- Gastrointestinal Surgery
Background:
- Gangrenous cholecystitis often necessitates prompt surgical intervention.
- Early conversion from laparoscopic to open cholecystectomy is a debated strategy.
Purpose of the Study:
- To evaluate the patient outcomes associated with early conversion during laparoscopic cholecystectomy for gangrenous cholecystitis.
Main Methods:
- Prospective analysis of 97 patients with gangrenous cholecystitis undergoing laparoscopic cholecystectomy with conversion to open surgery.
- Outcome measures included morbidity, length of stay, ICU admission, and operative time.
Main Results:
- No significant difference in overall morbidity was observed across conversion timing groups.
- Early conversion was associated with a significantly shorter operative time (p < 0.01).
- The length of hospital stay appeared longer in the early conversion group.
Conclusions:
- Laparoscopic cholecystectomy is not always feasible for gangrenous cholecystitis.
- Attempting a minimally invasive approach does not adversely affect patient outcomes.
- Early conversion offers potential benefits, including reduced operative time, despite a moderate risk.
