Conversion factors in laparoscopic cholecystectomy for acute cholecystitis

• Type: Article in International Scientific Journal
• Date: 2000

Authors

Araujo JP (Author) FMUP; Saraiva, AC (Author) Other; Cabral, AC (Author) Other; Barros H (Author) FMUP; Reis, JR (Author) Other; Teixeira, A (Author) Other

Journal

Title: Hepato-Gastroenterology

Vol. 47

Pages: 626-630

ISSN: 0172-6390

Publisher: Thieme

Indexing

ISI Web of Knowledge - 34 Citations

Scopus - 42 Citations

Other information

Authenticus ID: P-001-05C

Abstract (EN): Background/Aims: Although laparoscopic cholecystectomy already occupies an important role in acute cholecystitis, a high rate of conversion continues to be referred to in the series published. One of the objectives of this study is to assess the preoperative factors that might lead to conversion. Methodology: 100 laparoscopic cholecystectomies for acute cholecystitis were studied of which 24 were converted. Several parameters are taken into consideration: age, sex, ASA, ecographic data, bacteriological examination of the bile, time elapsing between diagnosis and surgery, morbidity and mortality. Results: The analysis made in relation to the preoperative, predetermining factors with regards to the converted cases provided the following elements in unvaried analysis: Preoperative existence of: "plastron" gallbladder (P < 0.002), temperature above 38 degrees C (P < 0.04), leucocytosis (P < 0.02)), time elapsing between diagnosis and surgery (P < 0.005), presence in the ecography of pericholecystic liquid (P < 0.0005) and edema (P < 0.001); Klebsiella in the gallbladder bile (P < 0.005). Age (P = 0.136), sex (P = 0.992), associated diseases (P = 0.961), and gallbladder pathology (P = 0.282) did not present statistical differences that would prevent valid conclusions. In multivaried analysis it was only possible to consider as independent factors the leucocytosis and the time between diagnosis and surgery. Conclusions: Laparoscopic cholecystectomy is a safe and efficient technique in the treatment of acute cholecystitis, which should constitute the first choice of treatment for this disease. However, it should be carried out within the first 4 days following surgical diagnosis.

Language: English

Type (Professor's evaluation): Scientific

No. of pages: 5