Volume 78, Issue 11 (February 2021)
Tehran Univ Med J 2021, 78(11): 726-732 |
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Noori E, Vahedian M, Savaddar F, Kachoie A, Eshraghi M, Minaei N. An investigational study about the conversion risk factors of laparoscopic cholecystectomy to open surgery. Tehran Univ Med J 2021; 78 (11) :726-732
URL: http://tumj.tums.ac.ir/article-1-11036-en.html
URL: http://tumj.tums.ac.ir/article-1-11036-en.html
Enayatollah Noori1 
, Mostafa Vahedian2 , Farrokh Savaddar3 , Ahmad Kachoie3 , Mohsen Eshraghi * 4, Neda Minaei1
, Mostafa Vahedian2 , Farrokh Savaddar3 , Ahmad Kachoie3 , Mohsen Eshraghi * 4, Neda Minaei1
1- Research Committee, Faculty of Medicine, Qom University of Medical Sciences, Qom, Iran.
2- Department of Family and Community Medicine, Faculty of Medicine, Qom University of Medical Sciences, Qom, Iran.
3- Department of Surgery, Faculty of Medicine, Qom University of Medical Sciences, Qom, Iran.
4- Department of Surgery, Faculty of Medicine, Qom University of Medical Sciences, Qom, Iran. , enayatnoori68@gmail.com
2- Department of Family and Community Medicine, Faculty of Medicine, Qom University of Medical Sciences, Qom, Iran.
3- Department of Surgery, Faculty of Medicine, Qom University of Medical Sciences, Qom, Iran.
4- Department of Surgery, Faculty of Medicine, Qom University of Medical Sciences, Qom, Iran. , enayatnoori68@gmail.com
Abstract: (1226 Views)
Background: Knowing the conversion risk factors of laparoscopic cholecystectomy to open surgery, helps the surgeon to plan for surgery accordingly. This study aimed to determine the risk factors for converting laparoscopic cholecystectomy to open surgery.
Methods: In this analytical study, the case information of 1104 patients who underwent laparoscopic cholecystectomy in Shahid Beheshti Hospital in Qom from April 2013 to April 2017 was evaluated. Inclusion criteria were all cases of acute cholecystitis, chronic cholecystitis, symptomatic gallstones, and biliary pancreatitis who underwent laparoscopic cholecystectomy. The exclusion criteria were patients who underwent laparoscopic cholecystectomy at the same time with other procedures. Data of all patients including age, sex, history of abdominal surgery, emergency or elective surgery, blood transaminase level, blood bilirubin level, white blood cell count, amylase level, and serum alkaline phosphatase were recorded. Finally, potential risk factors were compared between the two groups. Average, standard deviation, frequency and percentage indices were used to describe the data. Independent samples t‐test and Mann-Whitney U test were used for quantitative data analysis and Chi-square test was used for qualitative data analysis. P<0.05 is considered significant.
Results: 1104 patients were studied. 765 patients were female (69.3%) and 339 patients were male (30.7%). In 104 cases, open surgery was performed. The mean age of patients in the method change group was 49.45±8.9 years. Among the studied variables, between sex (P=0.26), age (P=0.056), process of cholecystitis (P=0.65), previous history of abdominal surgery (P=0.62), alanine transaminase (P=0.10) aspartate transaminase (P=0.95) showed no statistically significant relationship with the conversion of laparoscopic surgery to open surgery. However, abnormal ultrasound (P=0.000), emergency surgery (P=0.000), white blood cell count (P=0.008), total bilirubin and alkaline phosphatase (P=0.000) had a statistically significant relationship with the conversion of laparoscopic to open surgery
Methods: In this analytical study, the case information of 1104 patients who underwent laparoscopic cholecystectomy in Shahid Beheshti Hospital in Qom from April 2013 to April 2017 was evaluated. Inclusion criteria were all cases of acute cholecystitis, chronic cholecystitis, symptomatic gallstones, and biliary pancreatitis who underwent laparoscopic cholecystectomy. The exclusion criteria were patients who underwent laparoscopic cholecystectomy at the same time with other procedures. Data of all patients including age, sex, history of abdominal surgery, emergency or elective surgery, blood transaminase level, blood bilirubin level, white blood cell count, amylase level, and serum alkaline phosphatase were recorded. Finally, potential risk factors were compared between the two groups. Average, standard deviation, frequency and percentage indices were used to describe the data. Independent samples t‐test and Mann-Whitney U test were used for quantitative data analysis and Chi-square test was used for qualitative data analysis. P<0.05 is considered significant.
Results: 1104 patients were studied. 765 patients were female (69.3%) and 339 patients were male (30.7%). In 104 cases, open surgery was performed. The mean age of patients in the method change group was 49.45±8.9 years. Among the studied variables, between sex (P=0.26), age (P=0.056), process of cholecystitis (P=0.65), previous history of abdominal surgery (P=0.62), alanine transaminase (P=0.10) aspartate transaminase (P=0.95) showed no statistically significant relationship with the conversion of laparoscopic surgery to open surgery. However, abnormal ultrasound (P=0.000), emergency surgery (P=0.000), white blood cell count (P=0.008), total bilirubin and alkaline phosphatase (P=0.000) had a statistically significant relationship with the conversion of laparoscopic to open surgery
| Conclusion: Due to the high complications and mortality of open cholecystectomy, the detection of these risk factors helps to reduce the rate of open surgery and address these factors before surgery. |
Type of Study: Original Article |
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