Tags

Type your tag names separated by a space and hit enter

Risk factors of conversion in laparoscopic cholecystectomies for lithiasic acute cholecystitis. Results of a monocentric study and review of the literature.
Tunis Med 2019; 97(2):344-351TM

Abstract

INTRODUCTION

Nowadays, laparoscopic cholecystectomy has become the gold standard in the management of lithiasic acute cholecystitis. However, the rate of conversion to laparotomy remains considerable, greater than that of uncomplicated lithiasis. Some factors, related to the patient, the disease or the surgeon, are associated with a high risk of conversion.

AIM

To identify the factors associated with a significant risk of conversion in laparoscopic cholecystectomy for acute cholecystitis.

METHODS

Between January 2011 and December 2015, all patients operated on for acute cholecystitis at the Department of General and Digestive Surgery of Farhat Hached University Hospital of Sousse - Tunisia were divided into two groups: A for the laparoscopic approach and B for conversion. We compared the two groups.

RESULTS

The conversion rate was 21.9% (43 patients). At the end of this work, we found that the conversion rate was significantly increased for males (p = 0.044), ulcerative disease (p = 0.004), smokers (p = 0.007), ASA score = II (p = 0.005), abdominal guarding (p = 0.001), fever (p = 0.001), perivesicular effusion on ultrasound (p = 0.041), ultrasound Murphy's sign (p = 0.023), delayed cholecystectomy (p = 0.038), perivascular adhesions (p <10-3) and gangrenous cholecystitis (p = 0.009).

CONCLUSION

The conversion is sometimes badly perceived by the surgeon. However, it should in no way be considered a failure, but rather a change of strategy to ensure patient safety. Conversion should not be delayed, especially as risk factors have been identified.

Authors

No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31539093

Citation

Jarrar, Mohamed Salah, et al. "Risk Factors of Conversion in Laparoscopic Cholecystectomies for Lithiasic Acute Cholecystitis. Results of a Monocentric Study and Review of the Literature." La Tunisie Medicale, vol. 97, no. 2, 2019, pp. 344-351.
Jarrar MS, Fourati A, Fadhl H, et al. Risk factors of conversion in laparoscopic cholecystectomies for lithiasic acute cholecystitis. Results of a monocentric study and review of the literature. Tunis Med. 2019;97(2):344-351.
Jarrar, M. S., Fourati, A., Fadhl, H., Youssef, S., Mahjoub, M., Khouadja, H., ... Letaief, R. (2019). Risk factors of conversion in laparoscopic cholecystectomies for lithiasic acute cholecystitis. Results of a monocentric study and review of the literature. La Tunisie Medicale, 97(2), pp. 344-351.
Jarrar MS, et al. Risk Factors of Conversion in Laparoscopic Cholecystectomies for Lithiasic Acute Cholecystitis. Results of a Monocentric Study and Review of the Literature. Tunis Med. 2019;97(2):344-351. PubMed PMID: 31539093.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Risk factors of conversion in laparoscopic cholecystectomies for lithiasic acute cholecystitis. Results of a monocentric study and review of the literature. AU - Jarrar,Mohamed Salah, AU - Fourati,Amine, AU - Fadhl,Houssem, AU - Youssef,Sabri, AU - Mahjoub,Mohamed, AU - Khouadja,Hosni, AU - Hafsa,Alaeddine, AU - Mraidha,Mohamed Hedi, AU - Ghali,Amine, AU - Hamila,Fehmi, AU - Letaief,Rached, PY - 2019/9/21/entrez SP - 344 EP - 351 JF - La Tunisie medicale JO - Tunis Med VL - 97 IS - 2 N2 - INTRODUCTION: Nowadays, laparoscopic cholecystectomy has become the gold standard in the management of lithiasic acute cholecystitis. However, the rate of conversion to laparotomy remains considerable, greater than that of uncomplicated lithiasis. Some factors, related to the patient, the disease or the surgeon, are associated with a high risk of conversion. AIM: To identify the factors associated with a significant risk of conversion in laparoscopic cholecystectomy for acute cholecystitis. METHODS: Between January 2011 and December 2015, all patients operated on for acute cholecystitis at the Department of General and Digestive Surgery of Farhat Hached University Hospital of Sousse - Tunisia were divided into two groups: A for the laparoscopic approach and B for conversion. We compared the two groups. RESULTS: The conversion rate was 21.9% (43 patients). At the end of this work, we found that the conversion rate was significantly increased for males (p = 0.044), ulcerative disease (p = 0.004), smokers (p = 0.007), ASA score = II (p = 0.005), abdominal guarding (p = 0.001), fever (p = 0.001), perivesicular effusion on ultrasound (p = 0.041), ultrasound Murphy's sign (p = 0.023), delayed cholecystectomy (p = 0.038), perivascular adhesions (p <10-3) and gangrenous cholecystitis (p = 0.009). CONCLUSION: The conversion is sometimes badly perceived by the surgeon. However, it should in no way be considered a failure, but rather a change of strategy to ensure patient safety. Conversion should not be delayed, especially as risk factors have been identified. SN - 0041-4131 UR - https://www.unboundmedicine.com/medline/citation/31539093/Risk_factors_of_conversion_in_laparoscopic_cholecystectomies_for_lithiasic_acute_cholecystitis._Results_of_a_monocentric_study_and_review_of_the_literature DB - PRIME DP - Unbound Medicine ER -