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Laparoscopic cholecystectomy

Cause of conversions in 1,300 patients and analysis of risk factors

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Abstract

In 1,300 patients undergoing laparoscopic cholecystectomy (LC) 56 patients (4.3%) required conversion to open cholecystectomy (OC); 41 (73%) of the conversions were elective, whereas 15 (27%) were enforced. The causes of the 56 conversions are described and analyzed. Logistic regression analysis of 23 parameters identified the following data as associated with a higher risk for conversion: pain or rigidity in the right upper abdomen (P<0.01), thickening of the gallbladder wall on preoperative ultrasound (P<0.05), intraoperatively found dense adhesions to the gallbladder or in Calot's triangle (P<0.001), and intraoperatively found acute inflammation of the gallbladder (P<0.01). Clinical findings of an acute cholecystitis associated with intraoperative dense scarring in Calot's triangle were the best factors predicting conversion from LC to OC. As a result of the study we preoperatively select our patients for either LC or OC, and a difficult case is performed by a more experienced surgeon to keep conversion rate and complications low.

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Authors and Affiliations

  1. Second Surgical Unit, AKH Linz and the Ludwig Boltzmann Institute for Surgical Laparoscopy, Krankenhausstraße 9, A-4020, Linz, Austria

    P. Schrenk, R. Woisetschläger & W. U. Wayand

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  1. P. Schrenk
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  2. R. Woisetschläger
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  3. W. U. Wayand
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Schrenk, P., Woisetschläger, R. & Wayand, W.U. Laparoscopic cholecystectomy. Surg Endosc 9, 25–28 (1995). https://doi.org/10.1007/BF00187880

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  • DOI: https://doi.org/10.1007/BF00187880

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