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. 2016 Nov 16:11:54.
doi: 10.1186/s13017-016-0111-4. eCollection 2016.

Laparoscopic cholecystectomy for acute calculous cholecystitis: a retrospective study assessing risk factors for conversion and complications

Petra Maria Terho  1 , Ari Kalevi Leppäniemi  2 , Panu Juhani Mentula  2
Affiliations

Laparoscopic cholecystectomy for acute calculous cholecystitis: a retrospective study assessing risk factors for conversion and complications

Petra Maria Terho et al. World J Emerg Surg. .

Abstract

Background: The purpose of the study was to identify risk factors for conversion of laparoscopic cholecystectomy and risk factors for postoperative complications in acute calculous cholecystitis. The most common complications arising from cholecystectomy were also to be identified.

Methods: A total of 499 consecutive patients, who had undergone emergent cholecystectomy with diagnosis of cholecystitis in Meilahti Hospital in 2013-2014, were identified from the hospital database. Of the identified patients, 400 had acute calculous cholecystitis of which 27 patients with surgery initiated as open cholecystectomy were excluded, resulting in 373 patients for the final analysis. The Clavien-Dindo classification of surgical complications was used.

Results: Laparoscopic cholecystectomy was initiated in 373 patients of which 84 (22.5%) were converted to open surgery. Multivariate logistic regression identified C-reactive protein (CRP) over 150 mg/l, age over 65 years, diabetes, gangrene of the gallbladder and an abscess as risk factors for conversion. Complications were experienced by 67 (18.0%) patients. Multivariate logistic regression identified age over 65 years, male gender, impaired renal function and conversion as risk factors for complications.

Conclusions: Advanced cholecystitis with high CRP, gangrene or an abscess increase the risk of conversion. The risk of postoperative complications is higher after conversion. Early identification and treatment of acute calculous cholecystitis might reduce the number of patients with advanced cholecystitis and thus improve outcomes.

Keywords: Acute cholecystitis; Conversion; Laparoscopic cholecystectomy; Open cholecystectomy.

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References

    1. Coccolini F, Catena F, Pisano M, Gheza F, Fagiuoli S, Di Saverio S, et al. Open versus laparoscopic cholecystectomy in acute cholecystitis. Systematic review and meta-analysis. Int J Surg. 2015;18:196–204. doi: 10.1016/j.ijsu.2015.04.083. - DOI - PubMed
    1. Ansaloni L, Pisano M, Coccolini F, Peitzmann AB, Fingerhut A, Catena F, et al. 2016 WSES guidelines on acute calculous cholecystitis. World J Emerg Surg. 2016;11:25. doi: 10.1186/s13017-016-0082-5. - DOI - PMC - PubMed
    1. Kiviluoto T, Sirén J, Luukkonen P, Kivilaakso E. Randomised trial of laparoscopic versus open cholecystectomy for acute and gangrenous cholecystitis. Lancet. 1998;351:321–5. doi: 10.1016/S0140-6736(97)08447-X. - DOI - PubMed
    1. Boo YJ, Kim WB, Kim J, Song TJ, Choi SY, Kim YC, et al. Systemic immune response after open versus laparoscopic cholecystectomy in acute cholecystitis: A prospective randomized study. Scand J Clin Lab Invest. 2007;67:207–14. doi: 10.1080/00365510601011585. - DOI - PubMed
    1. Gurusamy K, Samraj K, Gluud C, Wilson E, Davidson BR. Meta-analysis of randomized controlled trials on the safety and effectiveness of early versus delayed laparoscopic cholecystectomy for acute cholecystitis. Br J Surg. 2010;97:141–50. doi: 10.1002/bjs.6870. - DOI - PubMed

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