Annals of Hepato-Biliary-Pancreatic Surgery (한국간담췌외과학회지)
- Volume 12 Issue 3
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- Pages.168-172
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- 2008
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- 2508-5778(pISSN)
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- 2508-5859(eISSN)
Comparative Clinical Analysis of 111 Laparoscopic Cholecystectomy Cases Converted to Open Procedures
복강경 담낭 절제술 2,523예 시행 중 개복술로 전환한 111예에 대한 임상적 고찰
- Bang, Ji-Sung (Department of Surgery, College of Medicine, Chung-Ang University) ;
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Choi, Yu-Sin
(Department of Surgery, College of Medicine, Chung-Ang University) ;
- Kim, Beom-Gyu (Department of Surgery, College of Medicine, Chung-Ang University) ;
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Cha, Sung-Jae
(Department of Surgery, College of Medicine, Chung-Ang University) ;
- Chi, Kyung-Choun (Department of Surgery, College of Medicine, Chung-Ang University) ;
- Lee, Jung-Hyo (Department of Surgery, College of Medicine, Chung-Ang University) ;
- Chang, In-Taik (Department of Surgery, College of Medicine, Chung-Ang University)
- 방지성 (중앙대학교 의과대학 외과학교실) ;
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최유신
(중앙대학교 의과대학 외과학교실) ;
- 김범규 (중앙대학교 의과대학 외과학교실) ;
-
차성재
(중앙대학교 의과대학 외과학교실) ;
- 지경천 (중앙대학교 의과대학 외과학교실) ;
- 이정효 (중앙대학교 의과대학 외과학교실) ;
- 장인택 (중앙대학교 의과대학 외과학교실)
- Published : 2008.09.30
Abstract
Purpose: While laparoscopic cholecystectomy can be successfully performed in the majority of patients, conversion to open procedure is still necessary in certain cases. The purpose of this study was to identify the discerning factors that helped to predict the need for conversion to open cholecystectomy. Methods: A retrospective review was conducted on the data for 2,523 laparoscopic cholecystectomies performed at Chung-Ang University Hospital between January 2002 and July 2007. Patient sex, age, height, weight, body mass index (BMI), duration of preoperative hospital stay, preoperative physical examination, laboratory data, radiologic findings, and reasons for conversion to open procedure were evaluated. Results: Adhesion was perceived to be the most critical factor for conversion in 56 of 111 total cases (50.5%). Bleeding (22.5%), bile duct injury (11.7%), inflammation (9.0%), and uncertain anatomy (6.3%) followed sequentially in incidence. Factors found to significantly increase the risk of conversion on univariate analysis were patient age >70 years, male sex, previous abdominal operation, preoperative common bile duct stone, tenderness in the right upper quadrant, distended shape of the gallbladder, and pericholecystic fluid collection. On multivariate analysis, the following factors were found to be associated with a higher risk: patient age >70 years (p=0.002), male sex (p=0.012), previous abdominal operation (p<0.0001), and preoperative common bile duct stone (p=0.041). Conclusion: In the case of operations with such discerning factors, surgeons should be more cautious and delicate in all procedures throughout the operative period. Furthermore, to reduce the risk of additional severe complications, surgeons need to decide early on if they will perform a conversion.