Conversion from laparoscopic to open cholecystectomy: Risk factor analysis based on clinical, laboratory, and...

Area of Science:

• Gastroenterology and Hepatobiliary Surgery
• Surgical Outcomes Research

Background:

• Laparoscopic cholecystectomy is standard for gallbladder disease.
• Conversion to open surgery increases morbidity.
• Identifying predictors of conversion in acute cholecystitis is crucial for personalized patient care.

Purpose of the Study:

• To identify risk factors for conversion from laparoscopic to open cholecystectomy in patients with acute cholecystitis.
• To develop a predictive model for conversion risk.

Main Methods:

• Retrospective case-control study of 321 patients with acute cholecystitis (2018 Tokyo Guidelines).
• Logistic regression analysis to identify risk factors for conversion.
• Multivariate analysis and exploratory analysis for risk factor summation pathway.

Main Results:

• 12.14% of cases (39/321) were converted to open surgery.
• Univariate analysis: older age, male sex, gallbladder wall thickness, and pericholecystic fluid predicted conversion.
• Multivariate analysis confirmed older age, male sex, and gallbladder wall thickness as significant predictors. Risk factor summation model achieved 84% sensitivity.

Conclusions:

• Preoperative clinical data effectively identifies patients at higher risk of conversion.
• Awareness of these risk factors aids in perioperative planning and preparedness for complex cases.