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Predictive factors for conversion to open surgery during laparoscopic cholecystectomy
Abstract
Aim. Laparoscopic cholecystectomy is the gold standard method in the treatment of elective symptomatic gallstones. In acute cholecystitis, the rate of conversion to an open procedure is 1525% higher when compared to elective cases. In this study we aimed to evaluate the effectiveness of patients’ preoperative features, as these may affect the decision to convert to open surgery. Methods. This single-center study was conducted between June 2007-2009 with 122 patients who were treated for acute cholecystitis. The primary objective was to define the criterias for C-reactive protein, erythrocyte sedimentation rate, white blood count, gender and age for conversion to open procedure. Results. A total of 102 patients were included in the study. Laparoscopic cholecystectomy was successfully performed in 75 patients; and open conversion was required in 27 patients. The analysis showed that male gender, erythrocyte sedimentation rate and C-reactive protein levels, and severe ultrasonographic findings of acute cholecystitis in the conversion group were significantly different than in the laparoscopy group and these parameters were independent predictive factors of conversion. Conclusion. Male gender, high erythrocyte sedimentation rate and C-reactive protein levels and severe ultrasonographic findings are predictive actors which may help facilitate a conversion to open surgery.
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Kaynakça
- Kum CK, Eypasch E, Lefering R, Paul A, Neugebauer E, Troidl H. Laparoscopic cholecystectomy for acute cholecystitis: Is it really safe? World J Surg 1996; 20: 43Adamsen S, Hansen OH, Funch-Jensen P, Schulze S, Stage JG, Wara P. Bile duct injury during laparoscopic cholecystectomy: a prospective nationwide series. J Am Coll Surg 1997; 184: 571-8.
- Cox MR, Wilson TG, Luck AJ, Jeans PL, Padbury RT, Toouli J. Laparoscopic cholecystectomy for acute inflammation of the gallbladder. Ann Surg 1993; 218: 630Zucker KA, Flowers JL, Bailey RW, Graham SM, Buell J, Imbembo AL. Laparoscopic management of acute cholecystitis. Am J Surg 1993; 165: 508-14. Bickel A, Rappaport A, Kanievski V, Vaksman I, Haj M, Geron N, Eitan A. Laparoscopic management of acute cholecystitis. Prognostic factors for success. Surg Endosc 1996; 10: 1045-9. van der Steeg HJ, Alexander S, Houterman S, Slooter GD, Roumen RM. Risk factors for conversion during laparoscopic cholecystectomy - experiences from a general teaching hospital. Scand J Surg 2011; 100: 169-73.
- Hirota M, Takada T, Kawarada Y, Nimura Y, Miura F, Hirata K, Mayumi T, Yoshida M, Strasberg S, Pitt H, Gadacz TR, de Santibanes E, Gouma DJ, Solomkin JS, Belghiti J, Neuhaus H, Büchler MW, Fan ST, Ker CG, Padbury RT, Liau KH, Hilvano SC, Belli G, Windsor JA, Dervenis C. Diagnostic criteria and severity assessment of acute cholecystitis: Tokyo Guidelines. J. Hepatobiliary Pancreat Surg 2007; 14: 78-82.
- Pessaux P, Tuech JJ, Rouge C, Duplessis R, Cervi C, Arnaud JP. Laparoscopic cholescystectomy in acute cholecystitis. Laparoscopic cholecystectomy in acute cholecystitis. A prospective comparative study in patients with acute vs. chronic cholecystitis. Surg Endosc 2000; 14: 358-61.
- Lipman JM, Claridge JA, Haridas M, Martin MD, Yao DC, Grimes KL, Malangoni MA. Preoperative findings predict conversion from laparoscopic to open cholecystectomy. Surgery 2007; 142: 556-63.
- Schafer M, Krahenbühl L, Büchler MW. Predictive factors for the type of surgery in acute cholecystitis. Am J Surg 2001; 182: 291-7.
- Jarvinen HJ, Hastbacka J. Early cholecystectomy for acute cholecystitis: A prospective randomized study. Ann Surg 1980; 191: 501-5.
- Lahtinen J, Alhava EM, Aukee S. Acute cholecystitis treated by early and delayed surgery. A controlled clinical trial. Scand J Gastroenterol 1978; 13: 673
Ayrıntılar
Birincil Dil
İngilizce
Konular
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Bölüm
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Yayımlanma Tarihi
23 Şubat 2013
Gönderilme Tarihi
23 Şubat 2013
Kabul Tarihi
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Yayımlandığı Sayı
Yıl 1970 Cilt: 35 Sayı: 4