Risk factors for conversion to open surgery in patients with acute cholecystitis undergoing interval laparoscopic cholecystectomy.
- Author:
Kok Ren LIM
1
;
Salleh IBRAHIM
;
Ngian Chye TAN
;
Swee Ho LIM
;
Khoon Hean TAY
Author Information
- Publication Type:Journal Article
- MeSH: Adult; Cholecystectomy, Laparoscopic; adverse effects; utilization; Cholecystitis, Acute; epidemiology; surgery; Female; Humans; Male; Middle Aged; Outcome Assessment (Health Care); Retrospective Studies; Risk Factors; Singapore
- From:Annals of the Academy of Medicine, Singapore 2007;36(8):631-635
- CountrySingapore
- Language:English
-
Abstract:
INTRODUCTIONLaparoscopic cholecystectomy for acute cholecystitis is associated with higher rate of conversion to laparotomy. The value of several factors that might influence the rate of conversion is analysed.
MATERIALS AND METHODSIn a retrospective analysis of a prospective database, the medical records of patients who underwent laparoscopic cholecystectomy from May 1998 to June 2004 were reviewed. Patients who had acute cholecystitis and had undergone interval laparoscopic cholecystectomy were included in this study.
RESULTSOut of 1000 laparoscopic cholecystectomies, 201 were operated on for acute cholecystitis. One hundred and forty-five patients (72.3%) underwent successful laparoscopic cholecystectomy and 56 patients (27.7%) needed conversion to open cholecystectomy. Patient's age (P = 0.031), total white cell count (P = 0.014), total bilirubin (P = 0.002), alkaline phosphatase (P = 0.003) and presence of common bile duct stone (P = 0.001) were found to be independently associated with conversion.
CONCLUSIONLaparoscopic cholecystectomy can be performed safely for acute cholecystitis. Predictors of conversion will be helpful when planning the laparoscopic approach and for counselling patients preoperatively.
