Risk Factors and Prevalence Associated With Conversion of Laparoscopic Cholecystectomy to Open Cholecystectomy: A Tertiary Care Hospital Experience in Western Mexico.

Autor:	Ochoa-Ortiz LI; Department of Surgery, Hospital Civil de Guadalajara Juan I. Menchaca, Guadalajara, MEX., Cervantes-Pérez E; Department of Internal Medicine, Hospital Civil de Guadalajara Fray Antonio Alcalde, Guadalajara, MEX.; Department of Clinics, Centro Universitario de Tlajomulco, Universidad de Guadalajara, Tlajomulco de Zuñiga, MEX., Ramírez-Ochoa S; Department of Internal Medicine, Hospital Civil de Guadalajara Fray Antonio Alcalde, Guadalajara, MEX., Gonzalez-Ojeda A; Biomedical Research Unit 02, Specialties Hospital - Western National Medical Center, Mexican Institute of Social Security, Guadalajara, MEX., Fuentes-Orozco C; Biomedical Research Unit 02, Specialties Hospital - Western National Medical Center, Mexican Institute of Social Security, Guadalajara, MEX., Aguirre-Olmedo I; Department of Surgery, Hospital Civil de Guadalajara Juan I. Menchaca, Guadalajara, MEX., De la Cerda-Trujillo LF; Department of Health-Illness, Universidad de Guadalajara, Tlajomulco de Zuñiga, MEX., Rodríguez-Navarro FM; Department of Surgery, Hospital Civil de Guadalajara Juan I. Menchaca, Guadalajara, MEX., Navarro-Muñiz E; Department of Surgery, Hospital México Americano, Guadalajara, MEX., Cervantes-Guevara G; Department of Welfare and Sustainable Development, Centro Universitario del Norte, Universidad de Guadalajara, Guadalajara, MEX.; Department of Gastroenterology, Hospital Civil de Guadalajara Fray Antonio Alcalde, Guadalajara, MEX.
Jazyk:	angličtina
Zdroj:	Cureus [Cureus] 2023 Sep 21; Vol. 15 (9), pp. e45720. Date of Electronic Publication: 2023 Sep 21 (Print Publication: 2023).
DOI:	10.7759/cureus.45720
Abstrakt:	Introduction Laparoscopic cholecystectomy (LC) is a common procedure used for the treatment of different pathologies caused by gallstones in the gallbladder, and one of the most common indications is acute cholecystitis. The definitive treatment for acute cholecystitis is surgery, and LC is the gold standard. Nevertheless, transoperative complications (like intraoperative bleeding, anatomical abnormalities of the gallbladder, etc.) of LC and some other preoperative factors (like dilatation of bile duct, increased gallbladder wall thickness, etc.) can cause or be a risk factor for conversion to open cholecystectomy (OC). The objective of this study was to determine the risk factors and prevalence associated with the conversion from LC to OC in patients with gallbladder pathology and the indication for LC. Materials and methods This was a prospective cohort study. We included patients of both sexes over 18 years of age with gallbladder disease. To determine the risk factors associated with conversion, we performed a bivariate analysis and then a multivariate analysis. Results The rate of conversion to OC was 4.54%. The preoperative factors associated with conversion, in the bivariate analysis, were common bile duct dilatation (p=0.008), emergency surgery (p=0.014), and smoking (p=0.001); the associated intraoperative variables were: laparoscopic surgery duration (p <0.0001), Calot triangle edema (p=0.033), incapacity to hold the gallbladder with atraumatic laparoscopic tweezers (p=0.036), and choledocholithiasis (p=0.042). Laparoscopic Surgery duration was the only factor with a significant association in the multivariate analysis (p=0.0036); we performed a receiver operating characteristic (ROC) curve analysis and found a cut-off point of 120 minutes for the duration of laparoscopic surgery with a sensitivity and a specificity of 67 and 88%, respectively. Conclusion The prevalence of conversion from LC to OC is similar to that reported in the international literature. The risk factors associated with conversion to OC, in this study, should be confirmed in future clinical studies, in this same population, with a larger sample size. Competing Interests: The authors have declared that no competing interests exist. (Copyright © 2023, Ochoa-Ortiz et al.)
Databáze:	MEDLINE
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