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CONVERSION FROM LAPAROSCOPIC CHOLECYSTECTOMY TO OPEN SURGERY: REASONS AND POSSIBLE RISKS: A SINGLE CENTER EXPERIENCE

Year 2022, Volume: 39 Issue: 3, 781 - 785, 30.08.2022

Abstract

Laparoscopic cholecystectomy has grown in popularity since its introduction and has become the gold standard surgical method for the treatment of cholelithiasis. It has several advantages over open surgery, including less postoperative pain, a shorter hospital stay, a faster return to normal activities, and bettercosmetic results. Converting from laparoscopic to open surgery may be necessary in some cases, either to prevent or treat difficulties. The current conversion rate from laparoscopic to open surgery is between 2 and 15%. Open surgery may be required due to advanced age, male gender, acute cholecystitis, anatomicalalterations of the gallbladder or biliary system, obesity, bleeding, adhesions, and biliary tract injuries. The purpose of our study was to determine the risk factors that influencethe conversion to open surgery.Between January 2018 and December 2021, 921 cholecystectomy cases were analyzed retrospectively at the Recep Tayyip Erdogan University Training and Research Hospital. Twenty-three of thesepatients were removed from the study once it was revealed that they had undergone direct open surgery or an open cholecystectomy while undergoing another operation. There were 28 patients in the study who had a laparoscopic cholecystectomy but had to convert to open surgery due to difficulties. The demographic and clinicalinformation about the patients was obtained from hospital records. By comparing the data of an equal number of randomlyselected patients from laparoscopic completed patients, it was assessed if these features had a significant effect on the conversion from laparoscopic to open surgery.The most common reason for conversion from laparoscopic to open cholecystectomy was adhesion due to inflammation, which accounted for 3.04 percent of conversions. In our study, cholecystitis symptomsincludingnumerous calculi on ultrasonography and increased wall thickness, as well as raised GGT and ALP levels, all affected the decision to convert to open surgery. There were no significant associationsdiscovered between gender, pancreatitis, cholangitis, stone size, and ASA score. The duration of hospitalization was found to be considerably longer in the group that converted to open surgery.Increased rates of conversion to open surgery are associated with advanced age, obesity, previous episodes of cholecystitis, adhesions due to previous abdominal incisions, presence of cholecystitis findings such as multiple calculi on ultrasonography and increased wall thickness, and high GGT and ALP values. The most effective factor in converting to open surgery appears to be having previously had cholecystitis. Preoperative patient examination can aid in predicting the risk of exposure.

References

  • 1- Soper, Nathaniel J., L. Michael Brunt, and Kurt Kerbl. "Laparoscopic general surgery." New England Journal of Medicine 330.6 (1994): 409-419.
  • 2- Sutcliffe R, Hollyman M, Hodson J, et al. Preoperative risk factors for conversion from laparoscopic to opencholecystectomy: a validated risk scorederived from a prospective U.K. database of 8820 patientsHPB (Oxford). 2016 Nov; 18(11): 922–928
  • 3- Acehan, Turker, and Emin Kose. "Risk Factors Effecting Conversion from Laparoscopic Cholecystectomy to Open Surgery/Kolesistektomi Esnasinda Laparoskopik Cerrahiden Acik Cerrahiye Gecisi Etkileyen Risk Faktorleri." Bagcilar Medical Bulletin 6.3 (2021): 280-287.
  • 4- Litwin, Demetrius EM, and Mitchell A. Cahan."Laparoscopic cholecystectomy." Surgical Clinics of North America 88.6 (2008): 1295-1313.
  • 5- Ekici Uğur, Faik Tatlı, and Murat Kanlıöz. "Preoperative and postoperative risk factors in laparoscopic cholecystectomy converted to opensurgery." Advances in Clinical and Experimental Medicine 28.7 (2019): 857-860.
  • 6- Beksac K, Turhan N, Karaagaoglu E. Risk Factors for Conversion of LaparoscopicCholecystectomy to Open Surgery: A New Predictive Statistical Model, J of Lap & Adv SurgTechVol. 26, Num 9, 2016.
  • 7- DiBuono, G., Romano, G., Galia, M. et al. Difficult laparoscopiccholecystectomy and preoperativepredictivefactors. SciRep 11, 2559 (2021). https://doi.org/10.1038/s41598-021-81938-6
  • 8- Gupta N, Ranjan G, Arora MP, Goswami B, Chaudhary P, Kapur A, et al. Validation of a scoring system to predict difficult laparoscopiccholecystectomy. Int J Surg 2013;11(9):1002-1006.
  • 9- ASA Physical Status Classification System, American Society of Anesthesiologists, Approved by the ASA House of Delegates on October 15, 2014, and last amended on December 13, 2020. Available from:https://www.asahq.org/standards-andguidelines/asa-physical-status-classification-system
  • 10- Atmaram DC, Lakshman K. Predictivefactors for conversion of laparoscopiccholecystectomy. Indian J Surg 2011;73(6):423-426.
  • 11- Vaccari S, Cervellera M, Lauro A, Palazzini G, Cirocchi R, Gjata A, et al. Laparoscopiccholecystectomy: which predictingfactors of conversion? Two Italiancenter’s studies. MinervaChir 2020;75:141-52. DOI: 10.23736/S0026-4733.20.08228-0
  • 12- Radunovic, Miodrag, et al. "Complications of laparoscopic cholecystectomy: our experience from a retrospective analysis." Open access Macedonian journal of medical sciences 4.4 (2016): 641.
  • 13- Kaafarani, Haytham MA, et al. "Trends, outcomes, and predictors of open and conversion to open cholecystectomy in Veterans Health Administration hospitals." The American Journal of Surgery 200.1 (2010): 32-40.
  • 14- Warchałowski, Łukasz, et al. "The analysis of risk factors in the conversion from laparoscopic to open cholecystectomy." International Journal of Environmental Research and Public Health 17.20 (2020): 7571.
  • 15- Güngör B, Bal A, Polat C, ve ark. Laparoskopik kolesistektomide açığa geçiş endikasyonları: Bir üniversite hastanesinin uzun dönem deneyimleri, Ege Journal of Medicine 50 (4): 243-246, 2011.
  • 16- Amin A, Haider M, Aamir I S, et al. (August 20, 2019) Preoperative and Operative Risk Factors for Conversion of Laparoscopic Cholecystectomy to Open Cholecystectomy in Pakistan. Cureus 11(8): e5446.doi:10.7759/cureus.5446)
  • 17- Lipman, Jeremy M., et al. "Preoperative findings predict conversion from laparoscopic to open cholecystectomy." Surgery 142.4 (2007): 556-565.
  • 18- S. Sözen , S. Emir and İ. Bali , "Laparoskopik Kolesistektomiden Açık Ameliyata Geçme Nedenleri", International Journal of Basic and Clinical Medicine, vol. 2, no. 1, pp. 8-13, Oct. 2015
  • 19- Kwon YH, Cho CM, Jung MK, Kim SG, Yoon YK. Risk factors of open converted cholecystectomy for cholelithiasis after endoscopicremoval of choledocholithiasis. DigDisSci 2015;60(2):550-556.
  • 20- Bourgouin S, Mancini J, Monchal T, et al. How to predıctdıffıcultlaparoscopıc cholecystectomy? Proposal for a sımplepreoperatıvescorıng system.Am J Surg2016 Nov 1;212(5):873-881.
  • 21- Rosen M, Brody F, Ponsky J, Predictive factors for conversion of laparoscopic cholecystectomy, The American Journal of Surgery 184 (2002) 254–258
  • 22- Licciardello, A., Arena, M., Nicosia, A., DiStefano, B., Cali, G., Arena, G., &Minutolo, V. (2014). Preoperative risk factors for conversion from laparoscopic to open cholecystectomy. EurRevMedPharmacolSci, 18(2 Suppl), 60-8.
Year 2022, Volume: 39 Issue: 3, 781 - 785, 30.08.2022

Abstract

References

  • 1- Soper, Nathaniel J., L. Michael Brunt, and Kurt Kerbl. "Laparoscopic general surgery." New England Journal of Medicine 330.6 (1994): 409-419.
  • 2- Sutcliffe R, Hollyman M, Hodson J, et al. Preoperative risk factors for conversion from laparoscopic to opencholecystectomy: a validated risk scorederived from a prospective U.K. database of 8820 patientsHPB (Oxford). 2016 Nov; 18(11): 922–928
  • 3- Acehan, Turker, and Emin Kose. "Risk Factors Effecting Conversion from Laparoscopic Cholecystectomy to Open Surgery/Kolesistektomi Esnasinda Laparoskopik Cerrahiden Acik Cerrahiye Gecisi Etkileyen Risk Faktorleri." Bagcilar Medical Bulletin 6.3 (2021): 280-287.
  • 4- Litwin, Demetrius EM, and Mitchell A. Cahan."Laparoscopic cholecystectomy." Surgical Clinics of North America 88.6 (2008): 1295-1313.
  • 5- Ekici Uğur, Faik Tatlı, and Murat Kanlıöz. "Preoperative and postoperative risk factors in laparoscopic cholecystectomy converted to opensurgery." Advances in Clinical and Experimental Medicine 28.7 (2019): 857-860.
  • 6- Beksac K, Turhan N, Karaagaoglu E. Risk Factors for Conversion of LaparoscopicCholecystectomy to Open Surgery: A New Predictive Statistical Model, J of Lap & Adv SurgTechVol. 26, Num 9, 2016.
  • 7- DiBuono, G., Romano, G., Galia, M. et al. Difficult laparoscopiccholecystectomy and preoperativepredictivefactors. SciRep 11, 2559 (2021). https://doi.org/10.1038/s41598-021-81938-6
  • 8- Gupta N, Ranjan G, Arora MP, Goswami B, Chaudhary P, Kapur A, et al. Validation of a scoring system to predict difficult laparoscopiccholecystectomy. Int J Surg 2013;11(9):1002-1006.
  • 9- ASA Physical Status Classification System, American Society of Anesthesiologists, Approved by the ASA House of Delegates on October 15, 2014, and last amended on December 13, 2020. Available from:https://www.asahq.org/standards-andguidelines/asa-physical-status-classification-system
  • 10- Atmaram DC, Lakshman K. Predictivefactors for conversion of laparoscopiccholecystectomy. Indian J Surg 2011;73(6):423-426.
  • 11- Vaccari S, Cervellera M, Lauro A, Palazzini G, Cirocchi R, Gjata A, et al. Laparoscopiccholecystectomy: which predictingfactors of conversion? Two Italiancenter’s studies. MinervaChir 2020;75:141-52. DOI: 10.23736/S0026-4733.20.08228-0
  • 12- Radunovic, Miodrag, et al. "Complications of laparoscopic cholecystectomy: our experience from a retrospective analysis." Open access Macedonian journal of medical sciences 4.4 (2016): 641.
  • 13- Kaafarani, Haytham MA, et al. "Trends, outcomes, and predictors of open and conversion to open cholecystectomy in Veterans Health Administration hospitals." The American Journal of Surgery 200.1 (2010): 32-40.
  • 14- Warchałowski, Łukasz, et al. "The analysis of risk factors in the conversion from laparoscopic to open cholecystectomy." International Journal of Environmental Research and Public Health 17.20 (2020): 7571.
  • 15- Güngör B, Bal A, Polat C, ve ark. Laparoskopik kolesistektomide açığa geçiş endikasyonları: Bir üniversite hastanesinin uzun dönem deneyimleri, Ege Journal of Medicine 50 (4): 243-246, 2011.
  • 16- Amin A, Haider M, Aamir I S, et al. (August 20, 2019) Preoperative and Operative Risk Factors for Conversion of Laparoscopic Cholecystectomy to Open Cholecystectomy in Pakistan. Cureus 11(8): e5446.doi:10.7759/cureus.5446)
  • 17- Lipman, Jeremy M., et al. "Preoperative findings predict conversion from laparoscopic to open cholecystectomy." Surgery 142.4 (2007): 556-565.
  • 18- S. Sözen , S. Emir and İ. Bali , "Laparoskopik Kolesistektomiden Açık Ameliyata Geçme Nedenleri", International Journal of Basic and Clinical Medicine, vol. 2, no. 1, pp. 8-13, Oct. 2015
  • 19- Kwon YH, Cho CM, Jung MK, Kim SG, Yoon YK. Risk factors of open converted cholecystectomy for cholelithiasis after endoscopicremoval of choledocholithiasis. DigDisSci 2015;60(2):550-556.
  • 20- Bourgouin S, Mancini J, Monchal T, et al. How to predıctdıffıcultlaparoscopıc cholecystectomy? Proposal for a sımplepreoperatıvescorıng system.Am J Surg2016 Nov 1;212(5):873-881.
  • 21- Rosen M, Brody F, Ponsky J, Predictive factors for conversion of laparoscopic cholecystectomy, The American Journal of Surgery 184 (2002) 254–258
  • 22- Licciardello, A., Arena, M., Nicosia, A., DiStefano, B., Cali, G., Arena, G., &Minutolo, V. (2014). Preoperative risk factors for conversion from laparoscopic to open cholecystectomy. EurRevMedPharmacolSci, 18(2 Suppl), 60-8.
There are 22 citations in total.

Details

Primary Language English
Subjects Health Care Administration
Journal Section Clinical Research
Authors

Ali Özdemir 0000-0002-6435-1868

Ahmet Karakaya 0000-0002-6638-0005

Ahmet Pergel 0000-0002-0163-887X

Early Pub Date August 30, 2022
Publication Date August 30, 2022
Submission Date March 29, 2022
Acceptance Date June 30, 2022
Published in Issue Year 2022 Volume: 39 Issue: 3

Cite

APA Özdemir, A., Karakaya, A., & Pergel, A. (2022). CONVERSION FROM LAPAROSCOPIC CHOLECYSTECTOMY TO OPEN SURGERY: REASONS AND POSSIBLE RISKS: A SINGLE CENTER EXPERIENCE. Journal of Experimental and Clinical Medicine, 39(3), 781-785.
AMA Özdemir A, Karakaya A, Pergel A. CONVERSION FROM LAPAROSCOPIC CHOLECYSTECTOMY TO OPEN SURGERY: REASONS AND POSSIBLE RISKS: A SINGLE CENTER EXPERIENCE. J. Exp. Clin. Med. August 2022;39(3):781-785.
Chicago Özdemir, Ali, Ahmet Karakaya, and Ahmet Pergel. “CONVERSION FROM LAPAROSCOPIC CHOLECYSTECTOMY TO OPEN SURGERY: REASONS AND POSSIBLE RISKS: A SINGLE CENTER EXPERIENCE”. Journal of Experimental and Clinical Medicine 39, no. 3 (August 2022): 781-85.
EndNote Özdemir A, Karakaya A, Pergel A (August 1, 2022) CONVERSION FROM LAPAROSCOPIC CHOLECYSTECTOMY TO OPEN SURGERY: REASONS AND POSSIBLE RISKS: A SINGLE CENTER EXPERIENCE. Journal of Experimental and Clinical Medicine 39 3 781–785.
IEEE A. Özdemir, A. Karakaya, and A. Pergel, “CONVERSION FROM LAPAROSCOPIC CHOLECYSTECTOMY TO OPEN SURGERY: REASONS AND POSSIBLE RISKS: A SINGLE CENTER EXPERIENCE”, J. Exp. Clin. Med., vol. 39, no. 3, pp. 781–785, 2022.
ISNAD Özdemir, Ali et al. “CONVERSION FROM LAPAROSCOPIC CHOLECYSTECTOMY TO OPEN SURGERY: REASONS AND POSSIBLE RISKS: A SINGLE CENTER EXPERIENCE”. Journal of Experimental and Clinical Medicine 39/3 (August 2022), 781-785.
JAMA Özdemir A, Karakaya A, Pergel A. CONVERSION FROM LAPAROSCOPIC CHOLECYSTECTOMY TO OPEN SURGERY: REASONS AND POSSIBLE RISKS: A SINGLE CENTER EXPERIENCE. J. Exp. Clin. Med. 2022;39:781–785.
MLA Özdemir, Ali et al. “CONVERSION FROM LAPAROSCOPIC CHOLECYSTECTOMY TO OPEN SURGERY: REASONS AND POSSIBLE RISKS: A SINGLE CENTER EXPERIENCE”. Journal of Experimental and Clinical Medicine, vol. 39, no. 3, 2022, pp. 781-5.
Vancouver Özdemir A, Karakaya A, Pergel A. CONVERSION FROM LAPAROSCOPIC CHOLECYSTECTOMY TO OPEN SURGERY: REASONS AND POSSIBLE RISKS: A SINGLE CENTER EXPERIENCE. J. Exp. Clin. Med. 2022;39(3):781-5.