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Published on: February 10, 2023
Risk factors for conversion to open surgery in patients undergoing laparoscopic cholecystectomy.
Salleh Ibrahim1, Tay Khoon Hean, Lim Swee Ho
1Department of Surgery, Changi General Hospital, 2nd Simei Street 3, Singapore 529889. salleh_ibrahim@cgh.com.sg
World Journal of Surgery
|August 24, 2006
Summary
Identifying risk factors for laparoscopic cholecystectomy conversion is crucial. Male gender, obesity, acute cholecystitis, prior surgery, and junior surgeons increase conversion rates.
Area of Science:
- Gastroenterology and Hepatobiliary Surgery
- Minimally Invasive Surgery
- Surgical Outcomes Research
Background:
- Laparoscopic cholecystectomy is the standard for gallbladder disease.
- Conversion to open surgery is sometimes necessary due to various factors.
- Identifying these factors improves patient care and surgical planning.
Purpose of the Study:
- To identify significant risk factors for conversion from laparoscopic to open cholecystectomy.
- To analyze patient demographics, medical history, and surgeon experience associated with conversion.
- To inform surgical strategy and patient counseling.
Main Methods:
- Retrospective analysis of 1000 laparoscopic cholecystectomies performed between May 1998 and May 2004.
- Prospective data collection with retrospective analysis of 103 cases requiring conversion.
- Statistical comparison of patient characteristics and outcomes between converted and non-converted groups.
Main Results:
- Conversion was more frequent in men, heavier patients (>65 kg), those with acute cholecystitis, and prior abdominal surgery (P < 0.001).
- Higher conversion rates were observed with junior surgeons (P < 0.032).
- Diabetes with HbA1c > 6% was associated with higher conversion rates (P < 0.038).
Conclusions:
- Key risk factors for conversion include male gender, age >60, weight >65 kg, acute cholecystitis, prior surgery, junior surgeons, and poorly controlled diabetes.
- Chronic liver disease and cirrhosis were not risk factors, indicating safety in cirrhotic patients.
- Understanding these factors aids in surgical planning, patient counseling, and departmental policy development.
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