Akademik Veri Yönetim Sistemi
Gazi Medical Journal, cilt.19, sa.2, ss.60-65, 2008 (Scopus)
Purpose: Although laparoscopic cholecystectomy (LC) is the gold standard treatment modality for cholelithiasis, there is still a risk of conversion to open cholecystectomy. The aim of this study was to evaluate the reasons for conversion from LC to open cholecystectomy (LCOC) and investigate the risk factors. Patients and Methods: A total of 536 patients who had been operated on for cholelithiasis in Gazi University School of Medicine between May 2002 and May 2006 and whose data were available were enrolled in the study. Patients were grouped as group 1 (n = 492), which was composed of patients who had undergone LC, and group 2 (n = 44), which was composed of patients who had undergone LCOC. Patients were retrospectively evaluated according to their demographic characteristics [age, sex, body mass index (BMI)) ASA (American Society of Anesthesiology] scores, clinical histories, previous abdominal operations, preoperative laboratory findings, abdominal ultrasonography (US), preoperative endoscopic retrograde cholangiopancreaticography (ERCP), and intraoperative findings. Results: LCOC had been performed in 44 patients (8.3%). Mean age was 49.5±12.6 in the LC group and 52.7±15.6 in the LCOC group (P> 0.05). Preoperative high levels of white blood cells, increased gall bladder wall thickness (≥ 5 mm), and the existence of pericholecystic fluid in abdominal US were the predictive factors for LCOC. High adhesion score (grade IV), difficulty in Callot dissection, appearance of acute cholecystitis, and bleeding were the intraoperative reasons for LCOC. Conclusion: LCOC is not regarded as a complication. The surgeon has to manage the operation plan evaluating the preoperative and especially intraoperative factors.