Predictive factors for conversion of laparoscopic cholecystectomy in patients with acute cholecystitis.

OBJECTIVES: Laparoscopic management of acute cholecystitis may still be associated with increased risk of complications and the conversion rate to open cholecystectomy is accordingly higher when compared to elective cases. The aim of this study was to evaluate preoperative factors associated with conversion in acute cholecystitis.

PATIENTS: The records of 108 patients who underwent early laparoscopic cholecystectomy for acute cholecystitis.

RESULTS: Of 108 patients, 19 (17.59%) needed conversion to open cholecystectomy. Fifteen patients who required conversion to open cholecystectomy had severe inflammation and adhesions obscuring the plane of dissection and anatomy around Calot's triangle. For the remaining four patients, conversion was also necessary because of uncontrolled bleeding. Linear regression analysis revealed that advanced age (p = 0.029), obesity (p = 0.024) and pericholecystic fluid at the USG (p = 0.009) were statistically significant risk factors for conversion.

CONCLUSION: The identified risk factors do not contraindicate laparoscopic cholecystectomy; however surgeons should avoid laparoscopy-associated complications by performing open operations when appropriate (Tab. 3, Ref. 26). Full Text (Free, PDF) www.bmj.sk.