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Different setups of laparoscopic cholecystectomy: conversion and complication rates: a retrospective cohort study
Hasan Kais1, Yehuda Hershkovitz1, Yassir Abu-Snina1
1Division of Surgery, Assaf Harofeh Medical Center, Zerifin, Israel(1).
Background:
Laparoscopic cholecystectomy (LC) is the gold standard treatment for gall bladder disease.
Methods:
We retrospectively reviewed charts of patients who underwent LC. Four LC groups were defined: elective LC - Group I; interval LC - Group II; LC during acute cholecystitis - Group III; and LC following percutaneous cholecystostomy (PCC) - Group IV.
Results:
The study comprised 1658 patients [mean age: 51.0 years (range 17-94)]: Group I: 1221 patients (73.6%); Group II: 271 patients (16.3%); Group III: 125 patients (7.6%); Group IV: 41 patients (2.5%). The operative time was significantly different between the groups (p < 0.05). The conversion rate was highest in Group III (24.8%) and was significantly higher than all the other groups. Group II had a higher conversion rate than Group I (p < 0.05). The length of hospital stay was not significantly different between Groups I and II (1.5 and 1.96 days, respectively), and between Groups III and IV (4.46 and 4.78 days, respectively). The differences between Groups I and II, and between Groups III and IV were significant. Complication rates were significantly different between Groups I (2.2%), II (5.6%), and III (13.6%) (p < 0.05.) There were no differences between Groups III and IV and there were no significant differences in 30-day readmission rates between the groups.
Conclusions:
The highest conversion and complication rates were encountered in patients undergoing LC during acute cholecystitis. A gradual increase of conversion and complication rates was noted between the groups of elective LC, interval LC and LC post PCC.