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KMID : 0978820030060010028
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Journal of the Korean Society of Endoscopic & Laparoscopic Surgeons
2003 Volume.6 No. 1 p.28 ~ p.32
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Analysis of the Preoperative Predictive Factors for Conversion from Laparoscopic to Open Cholecystectomy
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Keum Jae-Hwa
Lee Sang-Mok
Park Ho-Chul
Koh Suck-Hwan
Oh Soo-Myung
Yoon Choong
Hong Sung-Wha
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Abstract
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Purpose: Laparoscopic cholecystectomy is now a standard treatment modality for symptomatic gallbladder disease. However, some proportions of laparoscopic cholecystectomy have been converted to open surgery. If risk factors for conversion from laparoscopic to open cholecystectomy could be reliably identified preoperatively, these factors would aid surgeons in preoperative patient counseling, informed consent, and operative strategy.
Methods: Medical records of 504 patients undergoing LC from 1999 to 2001 were reviewed. Demographics, history, physical examination, laboratory findings, radiology data, operative note were reviewed.
Results: Fourteen (2.8%) laparoscopic cholecystectomies required conversion to open cholecystectomy. In univariate analysis, male sex, acute cholecystitis, past history of jaundice, and elevated total bilirubin level were significant predictors. However, in multivariate analysis using logistic regression analysis, only male sex was an independent predictor for conversion to open cholecystectomy (p=0.021).
Conclusion: Most previously reported predictive factors for conversion seem to be overcome by experience of laparoscopic surgeon. Only male sex was an independent predictor for conversion to open surgery.
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KEYWORD
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Laparoscopic cholecystectomy, Conversion, Open cholecystoctomy, Preoperative predictive factors
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