The Analysis of Risk Factors in the Conversion from Laparoscopic to Open Cholecystectomy

Łukasz Warchałowski, Edyta Łuszczki, Anna Bartosiewicz, Katarzyna Dereń, Marta Warchałowska, Łukasz Oleksy, Artur Stolarczyk and Robert Podlasek
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Łukasz Warchałowski: Department of General Surgery, Clinical Regional Hospital No. 2 in Rzeszów, 35-301 Rzeszów, Poland
Edyta Łuszczki: Institute of Health Sciences, Medical College of Rzeszów University, 35-959 Rzeszów, Poland
Anna Bartosiewicz: Institute of Health Sciences, Medical College of Rzeszów University, 35-959 Rzeszów, Poland
Katarzyna Dereń: Institute of Health Sciences, Medical College of Rzeszów University, 35-959 Rzeszów, Poland
Marta Warchałowska: NZOZ Primadent in Rzeszów, 35-301 Rzeszów, Poland
Łukasz Oleksy: Orthopaedic and Rehabilitation Department, Medical University of Warsaw, 02-091 Warszawa, Poland
Artur Stolarczyk: Orthopaedic and Rehabilitation Department, Medical University of Warsaw, 02-091 Warszawa, Poland
Robert Podlasek: Department of General Surgery, Clinical Regional Hospital No. 2 in Rzeszów, 35-301 Rzeszów, Poland

IJERPH, 2020, vol. 17, issue 20, 1-12

Abstract: Laparoscopic cholecystectomy is a standard treatment for cholelithiasis. In situations where laparoscopic cholecystectomy is dangerous, a surgeon may be forced to change from laparoscopy to an open procedure. Data from the literature shows that 2 to 15% of laparoscopic cholecystectomies are converted to open surgery during surgery for various reasons. The aim of this study was to identify the risk factors for the conversion of laparoscopic cholecystectomy to open surgery. A retrospective analysis of medical records and operation protocols was performed. The study group consisted of 263 patients who were converted into open surgery during laparoscopic surgery, and 264 randomly selected patients in the control group. Conversion risk factors were assessed using logistic regression analysis that modeled the probability of a certain event as a function of independent factors. Statistically significant factors in the regression model with all explanatory variables were age, emergency treatment, acute cholecystitis, peritoneal adhesions, chronic cholecystitis, and inflammatory infiltration. The use of predictive risk assessments or nomograms can be the most helpful tool for risk stratification in a clinical scenario. With such predictive tools, clinicians can optimize care based on the known risk factors for the conversion, and patients can be better informed about the risks of their surgery.

Keywords: conversion; laparoscopic cholecystectomy; open surgery; risk factors (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2020
References: View complete reference list from CitEc
Citations: View citations in EconPapers (1)

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