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[Conversion in laparoscopic cholecystectomy].

E Târcoveanu1, D Niculescu, St Georgescu

  • 1Centrul de Cercetare in Chirurgie Generală Clasică si Laparoscopică, Clinica I Chirurgie "II Tănăsescu-VI. Buţureanu", Universitatea de Medicină si Farmacie "Gr. T. Popa" Iaşi. etarco@iasi.mednet.ro

Chirurgia (Bucharest, Romania : 1990)
|December 24, 2005
PubMed
Summary
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Laparoscopic cholecystectomy (LC) is standard for gallstones, but conversion to open surgery occurs. Key predictors for conversion include acute cholecystitis, male gender, and gallbladder wall thickness.

Area of Science:

  • Surgical Gastroenterology
  • Minimally Invasive Surgery
  • Biliary Tract Surgery

Context:

  • Laparoscopic cholecystectomy (LC) is the preferred treatment for symptomatic gallstones.
  • Conversion to open cholecystectomy (OC) is sometimes necessary.
  • Identifying predictors of conversion is crucial for surgical planning.

Purpose:

  • To analyze factors contributing to difficult LC and conversion to OC.
  • To assess the impact of patient and disease factors on conversion rates.

Summary:

  • This study analyzed 8415 cholecystectomies, finding a 5.1% overall conversion rate from LC to OC.
  • Significant predictors for conversion included acute cholecystitis, choledocholithiasis, prior acute cholecystitis, male gender, and gallbladder wall thickness >6 mm.

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  • The conversion rate decreased significantly over time, suggesting improved surgical techniques and patient selection.

    • Impact:

    • The findings support limiting OC to patients with absolute contraindications to LC.
    • Early recognition of difficult situations and timely conversion decisions are vital.
    • This research aids in optimizing surgical approaches for gallstone disease.