Preoperative Risk Factors for Conversion from Laparoscopic to Open Cholecystectomy: A Systematic Review and Meta-Analysis

Roberta Magnano San Lio, Martina Barchitta, Andrea Maugeri, Serafino Quartarone, Guido Basile and Antonella Agodi ()
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Roberta Magnano San Lio: Department of Medical and Surgical Sciences and Advanced Technologies “GF Ingrassia”, University of Catania, 95123 Catania, Italy
Martina Barchitta: Department of Medical and Surgical Sciences and Advanced Technologies “GF Ingrassia”, University of Catania, 95123 Catania, Italy
Andrea Maugeri: Department of Medical and Surgical Sciences and Advanced Technologies “GF Ingrassia”, University of Catania, 95123 Catania, Italy
Serafino Quartarone: Department of General Surgery and Medical-Surgical Specialties, University of Catania, 95123 Catania, Italy
Guido Basile: Department of General Surgery and Medical-Surgical Specialties, University of Catania, 95123 Catania, Italy
Antonella Agodi: Department of Medical and Surgical Sciences and Advanced Technologies “GF Ingrassia”, University of Catania, 95123 Catania, Italy

IJERPH, 2022, vol. 20, issue 1, 1-15

Abstract: Laparoscopic cholecystectomy is a standard treatment for patients with gallstones in the gallbladder. However, multiple risk factors affect the probability of conversion from laparoscopic cholecystectomy to open surgery. A greater understanding of the preoperative factors related to conversion is crucial to improve patient safety. In the present systematic review, we summarized the current knowledge about the main factors associated with conversion. Next, we carried out several meta-analyses to evaluate the impact of independent clinical risk factors on conversion rate. Male gender (OR = 1.907; 95%CI = 1.254–2.901), age > 60 years (OR = 4.324; 95%CI = 3.396–5.506), acute cholecystitis (OR = 5.475; 95%CI = 2.959–10.130), diabetes (OR = 2.576; 95%CI = 1.687–3.934), hypertension (OR = 1.931; 95%CI = 1.018–3.662), heart diseases (OR = 2.947; 95%CI = 1.047–8.296), obesity (OR = 2.228; 95%CI = 1.162–4.271), and previous upper abdominal surgery (OR = 3.301; 95%CI = 1.965–5.543) increased the probability of conversion. Our analysis of clinical factors suggested the presence of different preoperative conditions, which are non-modifiable but could be useful for planning the surgical scenario and improving the post-operatory phase.

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: 2022
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