Conversion of laparoscopic to open cholecystectomy: An analysis of risk factors

E. A. Wiebke, A. L. Pruitt, Thomas Howard, L. E. Jacobson, T. A. Broadie, R. J. Goulet, D. F. Canal

Research output: Contribution to journalArticle

62 Citations (Scopus)

Abstract

Background: Identifying patients who are at risk for conversion from laparoscopic (LC) to open cholecystectomy (OC) has proven to be difficult. The purpose of this review was to identify factors that may be predictive of cases which will require conversion to laparotomy for completion of cholecystectomy. Methods: We reviewed 581 LCs initiated between July 1990 and August 1993 at a university medical center and recorded reasons for conversion to OC. Statistical analysis was then performed to identify factors predictive of increased risk for conversion. Results: Of the 581 LC initiated, 45 (8%) required OC for completion. Reasons for conversion included technical and mandatory reasons and equipment failure. By multivariate analysis, statistically significant risk factors for conversion included increasing age, acute cholecystitis, a history of previous upper abdominal surgery, and being a patient at the Veterans Affairs Medical Center (VAMC). Factors not increasing risk of conversion included gender and operating surgeon. Conclusions: We conclude that no factor alone can reliably predict unsuccessful LC, but that combinations of increasing age, acute cholecystitis, previous upper abdominal surgery, and VAMC patient result in high conversion rates. Patients with the defined risk factors may be counseled on the increased likelihood of conversion. However, LC can be safely initiated for gallbladder removal with no excess morbidity or mortality should conversion be required.

Original languageEnglish
Pages (from-to)742-745
Number of pages4
JournalSurgical Endoscopy and Other Interventional Techniques
Volume10
Issue number7
StatePublished - Jul 1996

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Cholecystectomy
Acute Cholecystitis
Veterans
Equipment Failure
Gallbladder
Laparotomy
Multivariate Analysis
Morbidity
Mortality

Keywords

  • Acute cholecystitis
  • Conversions
  • Laparoscopic cholecystectomy
  • Open cholecystectomy
  • Risk factors

ASJC Scopus subject areas

  • Surgery

Cite this

Wiebke, E. A., Pruitt, A. L., Howard, T., Jacobson, L. E., Broadie, T. A., Goulet, R. J., & Canal, D. F. (1996). Conversion of laparoscopic to open cholecystectomy: An analysis of risk factors. Surgical Endoscopy and Other Interventional Techniques, 10(7), 742-745.

Conversion of laparoscopic to open cholecystectomy : An analysis of risk factors. / Wiebke, E. A.; Pruitt, A. L.; Howard, Thomas; Jacobson, L. E.; Broadie, T. A.; Goulet, R. J.; Canal, D. F.

In: Surgical Endoscopy and Other Interventional Techniques, Vol. 10, No. 7, 07.1996, p. 742-745.

Research output: Contribution to journalArticle

Wiebke, EA, Pruitt, AL, Howard, T, Jacobson, LE, Broadie, TA, Goulet, RJ & Canal, DF 1996, 'Conversion of laparoscopic to open cholecystectomy: An analysis of risk factors', Surgical Endoscopy and Other Interventional Techniques, vol. 10, no. 7, pp. 742-745.
Wiebke, E. A. ; Pruitt, A. L. ; Howard, Thomas ; Jacobson, L. E. ; Broadie, T. A. ; Goulet, R. J. ; Canal, D. F. / Conversion of laparoscopic to open cholecystectomy : An analysis of risk factors. In: Surgical Endoscopy and Other Interventional Techniques. 1996 ; Vol. 10, No. 7. pp. 742-745.
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