Risk factors affecting conversion in patients undergoing laparoscopic cholecystectomy
| Autor: | Wei-Jie Zhang, Kun-lun Luo, Zhi-Tao Dong, Guozhong Wu, Jie-Ming Li |
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| Rok vydání: | 2008 |
| Předmět: |
Male
medicine.medical_specialty China Multivariate analysis Radiography medicine.medical_treatment Risk Assessment Postoperative Complications Cholelithiasis Risk Factors Laparotomy Preoperative Care Medicine Humans Risk factor Laparoscopic cholecystectomy Retrospective Studies business.industry General surgery Gold standard Retrospective cohort study General Medicine Length of Stay Middle Aged Prognosis Surgery Treatment Outcome Cholecystectomy Laparoscopic Cholecystectomy Female Morbidity business |
| Zdroj: | ANZ journal of surgery. 78(11) |
| ISSN: | 1445-2197 |
| Popis: | Background: Laparoscopic cholecystectomy is the gold standard in the treatment for cholelithiasis, but there are still some patients requiring conversion to open cholecystectomy for several factors. The objective of this study was to evaluate preoperative risk factors for conversion from laparoscopic to open cholecystectomy. Methods: One thousand two hundred and sixty-five laparoscopic cholecystectomies were carried out from January 2005 to January 2006 in our hospital. Preoperative clinical, laboratory and radiographic parameters of these patients were kept prospectively and analysed retrospectively. Results: Conversion to open cholecystectomy was needed in 94 patients (7.4%). The main reason for conversion was inability to safely display and identify anatomical structures of Calot’s triangle correctly secondary to severe inflammation or dense adhesions, Multivariate analysis identified male sex, with Murphy’s sign positive, gall bladder wall thickness > 4 mm and previous upper abdominal surgery as independent predictors of conversion rate to laparotomy. Conclusion: Preoperative risk factors evaluated by the present study confirm the likelihood of conversion. Recognition of these factors was important for understanding the characteristics of patients at a higher risk of conversion. Identifying risk factors will help the surgeon to plan and counsel the patients and introduce new policies. |
| Databáze: | OpenAIRE |
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