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Can Hemogram Parameters and Derived Ratios Predict Conversion From Laparoscopic to Open Cholecystectomy?
Mehmet Alperen Avci1, Can Akgün1, Omer Buk2
1General Surgery, Samsun University, Samsun, TUR.
Cureus
|October 1, 2024
Summary
Predicting conversion from laparoscopic to open cholecystectomy using lab tests is complex. While some inflammatory markers like neutrophil-to-lymphocyte ratio (NLR) showed differences, they weren't reliable predictors in this study.
Area of Science:
- Gastroenterology
- Surgical Oncology
- Clinical Pathology
Background:
- Laparoscopic cholecystectomy (LC) is the standard gallbladder removal surgery.
- Conversion to open surgery may be needed in complex LC cases.
- Predicting this conversion preoperatively is crucial for patient safety and surgical planning.
Purpose of the Study:
- To identify and evaluate laboratory parameters and ratios that predict conversion from LC to open surgery.
- To analyze associations between preoperative lab findings and surgical outcomes in cholecystectomy patients.
Main Methods:
- Retrospective cohort study of 160 patients undergoing LC between January 2018 and September 2023.
- Review of preoperative laboratory findings and surgical notes.
- Analysis of correlations between patient data and cholecystectomy groups (laparoscopic vs. converted to open).
Main Results:
- In emergency cases, lymphocyte count and LMR were associated with laparoscopic completion, while NLR and SIRI were linked to conversion.
- In elective cases, GGT and total bilirubin were significantly associated with conversion to open surgery.
- Logistic regression analysis did not find hematological parameters or ratios to be significant predictors of conversion.
Conclusions:
- Despite observed differences in certain lab markers (NLR, LMR), they are not significant predictors for LC conversion.
- Further prospective studies with larger cohorts are required to validate predictive factors for conversion from laparoscopic to open cholecystectomy.
