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Laparoscopic Conversion to Open Cholecystectomy: Is Incidental Gallbladder Cancer Any Different?

Trevor S Silva1, Matthew Firek2, Paul Albini3

  • 1Hepatobiliary Surgery, Portland Providence Medical Center, Portland, USA.

Cureus
|July 12, 2024
PubMed
Summary
This summary is machine-generated.

Conversion to open surgery for incidental gallbladder cancer leads to longer hospital stays and higher rates of sepsis and reoperation. Predicting which patients need conversion remains challenging, warranting further investigation into oncologic outcomes.

Keywords:
biliary cancerconversion to open cholecystectomygallbladder cancerincidental gallbladder cancerlaparoscopic cholecystectomy

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Area of Science:

  • Surgical Oncology
  • Gastroenterology
  • Abdominal Surgery

Background:

  • Most gallbladder cancers are discovered incidentally during surgery for other conditions.
  • Risk factors and outcomes for converting laparoscopic to open cholecystectomy in incidental gallbladder cancer are not well understood.

Purpose of the Study:

  • To identify risk factors for conversion to open cholecystectomy in patients with incidental gallbladder cancer.
  • To compare outcomes between laparoscopic and converted to open cholecystectomy for incidental gallbladder cancer.

Main Methods:

  • Analysis of the National Surgical Quality Improvement Program (NSQIP) database (2010-2019).
  • Inclusion of patients with incidental gallbladder cancer undergoing laparoscopic or converted to open cholecystectomy.
  • Statistical analysis using Chi-squared, Fisher's exact, and Mann-Whitney U tests.

Main Results:

  • Conversion to open surgery was associated with longer hospital stays (14 vs 2 days) and higher rates of postoperative sepsis (50% vs 0%) and reoperation (50% vs 2.2%).
  • No significant differences in preoperative profiles were observed between laparoscopic and converted groups.
  • Lower preoperative sodium levels were noted in the converted group (P=0.007).

Conclusions:

  • Patients converted to open surgery for incidental gallbladder cancer experience worse outcomes, including prolonged hospitalization and increased sepsis and reoperation rates.
  • Predicting the need for conversion remains difficult.
  • Further research is needed to determine if complicated recovery impacts oncologic outcomes.