Laparoscopic to open cholecystectomy: The risk factors and the reasons; A retrospective analysis of 1950 cases of a single tertiary center

KARA Y., Kalayci M. U.

Surgical Laparoscopy, Endoscopy and Percutaneous Techniques, cilt.30, sa.2, ss.192-195, 2020 (SCI-Expanded, Scopus)

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 30 Sayı: 2
  • Basım Tarihi: 2020
  • Doi Numarası: 10.1097/sle.0000000000000716
  • Dergi Adı: Surgical Laparoscopy, Endoscopy and Percutaneous Techniques
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, CINAHL, EMBASE, MEDLINE
  • Sayfa Sayıları: ss.192-195
  • Anahtar Kelimeler: laparoscopic cholecystectomy, conversion to open, complications, risk factors, reasons
  • Sağlık Bilimleri Üniversitesi Adresli: Evet

Özet

Purpose:We investigated the reasons, rates, and risk factors for the conversion to open cholecystectomies (CTOC) by statistical analysis with the demographic properties.Materials and Methods:Demographic properties (age and sex), abdominal operations, and intraoperative and postoperative reasons for cholecystectomies were analyzed in 1950 patients.Results:The patients included 1540 (79%) women and 410 (21%) men (F/M=3.8); of these 115 (5.9%) had CTOC in early or late period. The rate of CTOC in men was significantly high (P= 0.009). There was no mortality. The reasons for CTOC were: significant inflammation (n=53, 46%), inadequate dissection of Calot triangle due to fibrotic adhesions (n=31, 27%), adhesions of previous surgery (n=9, 7.8%), uncontrollable bleeding (n=5, 4.3%), technical insufficiency (n=5, 4.3%), bile duct injury (n=5, 4.3%), anatomical variations (n=3, 2.6%), iatrogenic visceral injury (n=2, 1.7%), isolated right posterior bile duct injury (strasberg type-C) (n=1, 0.9%), and common hepatic duct partial injury (n=1, 0.9%).Conclusions:Significant inflammation, inadequate dissection of Calot triangle due to fibrotic adhesions, and adhesions due to previous surgery were the 3 main reasons for conversion. Men and elderly patients were associated with significantly high rate of conversion.