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ANALYSIS OF THE PREDICTIVE FACTORS FOR CONVERSION OF LAPAROSCOPIC CHOLECYSTECTOMY TO OPEN CHOLECYSTECTOMY | ||
| IRAQI JOURNAL OF MEDICAL SCIENCES | ||
| Article 1, Volume 6, Issue 3, 2008, Pages 20-27 | ||
| Author | ||
| Anees K. Nile | ||
| Abstract | ||
| Background: Laparoscopic cholecystectomy is the gold standard treatment for most gallbladder diseases. Identification of group of patients who are at increased (risk) for conversion from laparoscopic (LC) to open cholecystectomy (OC) has proven to be difficult. The purpose of our study is to identify factors that may be predictive of cases that will require conversion. Identifying these factors will help the patient,the surgeon, and the hospital. Objective: To identify the group of patients who are at increased risk for conversion from laparoscopic to open cholecystectomy. Patients and Methods: In this prospective study, we reviewed 85 patients undergoing laparoscopic cholecystectomy during the last three years (January 1, 2005 to January 31, 2008) at Al-Kadhimiya teaching hospital and Al-Husseiny hospital in Kerbala and recorded reasons for conversion to OC. Statistical analysis was then performed to identify factors predictive of increased risk for conversion. Results: Of the 85 LC initiated, 18 (21%)required OC for completion. The significant risk factors for conversion to OC were: little experience of the surgeon, male sex patient,increasing age of patients and gall bladder wall thickness >4 mm by preoperative ultrasound image. Conclusion: The need for conversion to laparotomy is neither a failure nor a complication, but an attempt to avoid complications. We conclude that no factor alone can reliably predict unsuccessful LC, but that combinations of factors (multifactorial) result in high conversion rates. Patients with the defined risk factors may be counseled on the increased likelihood of conversion. However, LC can be safely initiated for gallbladder removal with no excess morbidity or mortality should conversion be required. | ||
| Keywords | ||
| Laparoscopic cholecystectomy; OPEN CHOLECYSTECTOMY; CONVERSION; PREDICTIVE FACTORS | ||
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