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Laparoskopik kolesistektomide konversiyona neden olan faktörler

Year 2024, Volume: 11 Issue: 1, 37 - 41, 31.03.2024
https://doi.org/10.52880/sagakaderg.1287730

Abstract

Giriş ve Amaç: Laparoskopik kolesistektomi, semptomatik safra kesesi hastalığının tedavisi için altın standart cerrahi prosedürdür. Konversiyon bir başarısızlık ve bir komplikasyon değildir. Sadece hasta güvenliğini sağlamak ve komplikasyonlardan kaçınmak için atılan bir adımdır. Çalışmamızda laparoskopik kolesistektomi yapılan hastalarda konversiyon sıklığı ve konversiyona neden olan intraoperatif ve preoperatif faktörleri araştırmaktır. Gereç ve Yöntem: Hastanemizde kolelitiazis-kolesistit belirtileri ve semptomları olan ve batın ultrasonografisi ile teşhis konulan 4433 hastaya yapılan laparoskopik kolesistektomi vakaları retrospektif olarak incelendi. Hastalar yaş, cinsiyet, hastanede yatış süresi, önceden endoskopik retrograd kolanjio pankreatikografi (ERCP) yapılan, diabetes mellitus (DM), kronik firotik kolesistit, safra kesesi polibi, acil-elektif cerrahi olarak gruplara ayrıldı. Hastalarda konversiyon oranı ve neden olan faktörler araştırıldı. İstatistiksel testler için IBM SPSS for Windows, version 17,0 (IBM statistics for Windows version 17,0 IBM Corparation, Armonk, New York, United States) programı kullanıldı. Bulgular: Çalışmamızda konversiyon oranı % 0,85 idi. Erkek cinsiyet, hastanede yatış süresi, önceden ERCP uygulanması ve acil cerrahi uygulaması (akut-hidropik kolesistit), kronik fibrotik kolesistit gibi durumlar konversiyon grubu lehine anlamlı oranda fark olduğu görüldü. DM’ un konversiyon üzerine anlamlı ilişkisi bulunmadı. Sonuç: Konversiyon bir komplikasyon olarak görülmemelidir. Konversiyon hastanede kalış süresini uzatması ve maliyeti arttırmasına rağmen, olası komplikasyonları önlemeye yardımcı olarak maliyetin daha da artmasını önler. Konversiyon nedenlerinin tahmin edilmesi, cerrahın intraoperatif karşılaşabileceği potansiyel zorluklar hakkında bir fikir edinmesine yardımcı olabilir.

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References

  • Albrecht, R, Franke, K, Koch, H, Saeger, H.D. (2016). Prospektive Evaluation von Risikofaktoren bezüglich intraoperativer Konversion von laparoskopischer zu offener Cholezystektomie [Prospective Evaluation of Risk Factors Concerning Intraoperative Conversion from Laparoscopic to Open Cholecystectomy] Zentralbl. Chir. 141:204–209. doi: 10.1055/s-0032-1328348.
  • Ballal, M, David, G, Willmott, S, Corless, D.J, Deakin M, Slavin, J.P. (2009). Conversion after LC in England.Surg. Oct; 23 (10):2338-44. doi: 10.1007/s00464-009-0338-1. Epub 2009 M
  • Bittner R. (2006). Laparoscopic surgery: 15 years after clinical introduction. World J Surg.30:1190- 203 Botaitis, S, Pitiakoudis, M, Perente, S, Tripsianis, G, Polychronidis, A, Simopoulos, C (2012). LC in acute cholecystitis: an analysis of the risk factors. S Afr J Surg 50:62, 64, 68.
  • Coelho, J.C.U, Dalledone, G.O, Schiel, W, de Pauli Berbardin, J, Claus, C, Matias, J, de Freitas, A. (2019). Does male gender increase the risk of laparoscopic cholecystectomy? Arq. Bras. Cir. Dig. 32:e1438. doi: 10.1590/0102-672020190001e1438.
  • Domínguez, L.C, Rivera, A, Bermúdez, C, Herrer, W (2011). Analysis of factors for conversion of laparoscopic to open cholecystectomy: a prospective study of 703 patients with acute cholecystitis Cirugia Espanola, 89 (5), pp. 300-306
  • Ercan, M, Bostanci, E.B, Teke, Z, Karaman, K, Dalgic, T, Ulas, M & Akoglu, M. (2010). Predictive factors for conversion to open surgery in patients undergoing elective laparoscopic cholecystectomy. Journal of Laparoendoscopic & Advanced Surgical Techniques, 20 (5), 427-434.
  • Ercan, M, Bostanci, E.B, Ulas, M, Ozer, I, Ozogul, Y, Seven, C, et al. (2009). Effects of previous abdominal surgery incision type on complications and conversion rate in laparoscopic cholecystectomy. Surg Laparosc Endosc Percutan Tech. 19:373–8. 10.1097/SLE.0b013e3181b92935
  • Ganapathi, A.M, Speicher, P.J, Englum, B.R, Perez, A, Tyler, D.S, Zani, S. (2015). Gangrenous cholecystitis: a contemporary review. J Surg Res. 197:18–24.
  • Genc, V, Sulaimanov, M, Cipe, G, Basceken, S.I, Erverdi N, Gurel, M, Aras, N and Hazinedaroglu S.M. (2011). What necessitates the conversion to open cholecystectomy? A retrospective analysis of 5164 consecutive laparoscopic operations. Clinics (Sao Paulo). Mar; 66 (3): 417–420. doi:10.1590/S1807-59322011000300009
  • Ghnnam, W, Malek, J, Shebl, E, Elbeshry, T, Ibrahim, A. (2010). Rate of conversion and complications of LC in a tertiary care center in Saudi Arabia. Ann Saudi Med. 30 (2):145-8
  • Gómez, N.A, Zapatier, J, Vargas, P.E. (2006). Established advantages of minilaparotomy cholecystectomy versus laparoscopic cholecystectomy. Cir Esp. 79 (2):130-131
  • Henneman, D, Da Costa, D.W, Vrouenraets, B.C, Van Wagensveld, B.A, Lagarde, S.M. (2013). Laparoscopic partial cholecystectomy for the difficult gallbladder: A systematic review. Surg Endosc Interv Tech.27 (2):351-358. doi:10.1007/s00464-012-2458-2
  • Hori, T, Oike, F, Furuyama H, Machimoto, T, Kadokawa, Y, Hata, T, et al. (2016). Protocol for laparoscopic cholecystectomy: Is it rocket science World J. Gastroenterol. 22 (47):10287- 10303. doi:10.3748/wjg.v22.i47.10287
  • Ibrahim, S, Hean, T.K, Ho, L.S, Ravintharan, T, Chye, T.N, Chee, C.H. (2006). Risk factors for conversion to open surgery in patients undergoing laparoscopic cholecystectomy. World J Surg 30:1698–1704.
  • Kanaan, S.A, Murayama, K.M, Merriam, L.T, Dawes, L.G, Prystowsky, J.B, Rege, R.V, et al. (2002). Risk factors for conversion of laparoscopic to open cholecystectomy. J Surg Res. 106 (1):20-4.
  • Lee, N.W, Collins, J, Britt, R, Britt, L.D. (2012). Evaluation of preoperative risk factors for converting laparoscopic to open cholecystectomy. Am. Surgeon. 78:831–833. doi: 10.1177/000313481207800815.
  • Livingston, E.H, Rege, R.V. (2004). A nationwide study of conversion from laparoscopic to open cholecystectomy. Am J Surg. 188 (3):205-211
  • Stanisic, V, Milicevic, M, Kocev, N, Stojanovic, M, Vlaovic, D, Babic, I & Vucetic, N. (2014). Prediction of difficulties in LC on the base of routinely available parameters in a smaller regional hospital. Eur Rev Med Pharmacol Sci,18 (8), 1204-11.
  • Steeg, H.J.J, Alexander, S, Houterman, S, Slooter, G.D, Roumen, R.M.H. (2011). Risk factors for conversion during LC experiences from a general teaching hospital. Scandinavian J Surg. 100:169-73
  • Sultan, A.M, El Nakeeb, A, Elshehawy, T, Elhemmaly, M, Elhanafy, E, Atef E. (2013). Risk factors for conversion during laparoscopic cholecystectomy: retrospective analysis of ten years’ experience at a single tertiary referral centre. Dig Surg 30:51–55.
  • Tazuma, S, Unno, M, Igarashi, Y, Inui, K, Uchiyama, K, Kai, M, Tsuyuguchi, T, Maguchi, H, Mori, T, Yamaguchi, K, et al. (2017). Evidence-based clinical practice guidelines for cholelithiasis 2016. J. Gastroenterol. 52:276–300. doi: 10.1007/s00535-016-1289-7.
  • Teng, Fei Yang, Lin, Guo, Qiang, Wang. (2014). Evaluation of Preoperative Risk Factor for Converting Laparoscopic to Open Cholecystectomy: A Meta Analysis. Hepatogastroenterology. Jun;61 (132):958-65.
  • Turgut, A.N.U.K, Kahramanca, Ş. (2017). Laparoskopik Kolesistektomiden Açık Kolesistektomiye Dönüşü Etkileyen Faktörler. Gümüşhane Üniversitesi Sağlık Bilimleri Dergisi, 6.3: 50-55.
  • Wolf, A.S, Nijsse, B.A, Sokalm, S.M, Chang, Y, Berger, D.L. (2009). Surgical outcomes of open cholecystectomy in the laparoscopic era. Am. J. Surg. 197:781–784. Doi 10.1016/j.amjsurg.2008.05.010.
  • Yajima, H, Kanai, H, Son, K, Yoshida, K, Yanaga, K (2014). Reasons and risk factors for intraoperative conversion from laparoscopic to open cholecystectomy. Surg Today 44:80–83.
  • Yajima, H, Kanai, H, Son, K, Yoshida, K, Yanaga, K. (2014). Reasons and risk factors for intraoperative conversion from laparoscopic to open cholecystectomy. Surg Today 44:80–83.
  • Yang, T.F, Guo, L, Wang, Q. (2014). Evaluation of Preoperative Risk Factor for Converting Laparoscopic to Open Cholecystectomy: AtaMeta-Analysis. Hepato-Gastroenterology. 61:958–965.

Factors causing conversion in laparoscopic cholecystectomy

Year 2024, Volume: 11 Issue: 1, 37 - 41, 31.03.2024
https://doi.org/10.52880/sagakaderg.1287730

Abstract

Introduction and purpose: Laparoscopic cholecystectomy (LC) is the gold standard surgical procedure in the treatment symptomatic gall bladder disease. Conversion is not a failure or complication. It is only a step taken to ensure patient safety and to avoid complications. The objective of our study was to investigate the rate and the causative preoperative and intraoperative factors of conversion and to help surgeons have an idea about potential intraoperative challenges. Materials and methods: Laparoscopic cholecystectomy procedures performed on 4433 patients with signs and symptoms of cholelithiasis-cholecystitis who were diagnosed with abdominal ultrasonography were retrospectively reviewed. The patients were grouped on the basis of age, gender, length of hospitalization, history of preoperative endoscopic retrograde cholangiopancreaticography (ERCP), diabetes mellitus (DM), chronic fibrotic cholecystitis, gall bladder polyps, and urgent-elective surgery. The rate and causative factors of conversion were investigated. Statistical analyses were carried out using IBM SPSS for Windows, version 17.0 (IBM statistics for Windows version 17, IBM Corparation, Armonk, New York, United States) software package. Result: In our study, the conversion rate was 0.85%. Male gender, advanced age, increased length of hospitalization, history of preoperative ERCP, urgent surgery (acute-hydropic cholecystitis), and chronic fibrotic cholecystitis were the significant risk factors for conversion. DM had no effect on conversion. Conclusion: Conversion should not be necessarily regarded as a complication in laparoscopic cholecystectomy. Identifying patients with significant risk factors for conversion can significantly minimize the complications of the laparoscopic procedure. This may assist in identifying high-risk patients and reviewing surgical strategy in this patient group.

References

  • Albrecht, R, Franke, K, Koch, H, Saeger, H.D. (2016). Prospektive Evaluation von Risikofaktoren bezüglich intraoperativer Konversion von laparoskopischer zu offener Cholezystektomie [Prospective Evaluation of Risk Factors Concerning Intraoperative Conversion from Laparoscopic to Open Cholecystectomy] Zentralbl. Chir. 141:204–209. doi: 10.1055/s-0032-1328348.
  • Ballal, M, David, G, Willmott, S, Corless, D.J, Deakin M, Slavin, J.P. (2009). Conversion after LC in England.Surg. Oct; 23 (10):2338-44. doi: 10.1007/s00464-009-0338-1. Epub 2009 M
  • Bittner R. (2006). Laparoscopic surgery: 15 years after clinical introduction. World J Surg.30:1190- 203 Botaitis, S, Pitiakoudis, M, Perente, S, Tripsianis, G, Polychronidis, A, Simopoulos, C (2012). LC in acute cholecystitis: an analysis of the risk factors. S Afr J Surg 50:62, 64, 68.
  • Coelho, J.C.U, Dalledone, G.O, Schiel, W, de Pauli Berbardin, J, Claus, C, Matias, J, de Freitas, A. (2019). Does male gender increase the risk of laparoscopic cholecystectomy? Arq. Bras. Cir. Dig. 32:e1438. doi: 10.1590/0102-672020190001e1438.
  • Domínguez, L.C, Rivera, A, Bermúdez, C, Herrer, W (2011). Analysis of factors for conversion of laparoscopic to open cholecystectomy: a prospective study of 703 patients with acute cholecystitis Cirugia Espanola, 89 (5), pp. 300-306
  • Ercan, M, Bostanci, E.B, Teke, Z, Karaman, K, Dalgic, T, Ulas, M & Akoglu, M. (2010). Predictive factors for conversion to open surgery in patients undergoing elective laparoscopic cholecystectomy. Journal of Laparoendoscopic & Advanced Surgical Techniques, 20 (5), 427-434.
  • Ercan, M, Bostanci, E.B, Ulas, M, Ozer, I, Ozogul, Y, Seven, C, et al. (2009). Effects of previous abdominal surgery incision type on complications and conversion rate in laparoscopic cholecystectomy. Surg Laparosc Endosc Percutan Tech. 19:373–8. 10.1097/SLE.0b013e3181b92935
  • Ganapathi, A.M, Speicher, P.J, Englum, B.R, Perez, A, Tyler, D.S, Zani, S. (2015). Gangrenous cholecystitis: a contemporary review. J Surg Res. 197:18–24.
  • Genc, V, Sulaimanov, M, Cipe, G, Basceken, S.I, Erverdi N, Gurel, M, Aras, N and Hazinedaroglu S.M. (2011). What necessitates the conversion to open cholecystectomy? A retrospective analysis of 5164 consecutive laparoscopic operations. Clinics (Sao Paulo). Mar; 66 (3): 417–420. doi:10.1590/S1807-59322011000300009
  • Ghnnam, W, Malek, J, Shebl, E, Elbeshry, T, Ibrahim, A. (2010). Rate of conversion and complications of LC in a tertiary care center in Saudi Arabia. Ann Saudi Med. 30 (2):145-8
  • Gómez, N.A, Zapatier, J, Vargas, P.E. (2006). Established advantages of minilaparotomy cholecystectomy versus laparoscopic cholecystectomy. Cir Esp. 79 (2):130-131
  • Henneman, D, Da Costa, D.W, Vrouenraets, B.C, Van Wagensveld, B.A, Lagarde, S.M. (2013). Laparoscopic partial cholecystectomy for the difficult gallbladder: A systematic review. Surg Endosc Interv Tech.27 (2):351-358. doi:10.1007/s00464-012-2458-2
  • Hori, T, Oike, F, Furuyama H, Machimoto, T, Kadokawa, Y, Hata, T, et al. (2016). Protocol for laparoscopic cholecystectomy: Is it rocket science World J. Gastroenterol. 22 (47):10287- 10303. doi:10.3748/wjg.v22.i47.10287
  • Ibrahim, S, Hean, T.K, Ho, L.S, Ravintharan, T, Chye, T.N, Chee, C.H. (2006). Risk factors for conversion to open surgery in patients undergoing laparoscopic cholecystectomy. World J Surg 30:1698–1704.
  • Kanaan, S.A, Murayama, K.M, Merriam, L.T, Dawes, L.G, Prystowsky, J.B, Rege, R.V, et al. (2002). Risk factors for conversion of laparoscopic to open cholecystectomy. J Surg Res. 106 (1):20-4.
  • Lee, N.W, Collins, J, Britt, R, Britt, L.D. (2012). Evaluation of preoperative risk factors for converting laparoscopic to open cholecystectomy. Am. Surgeon. 78:831–833. doi: 10.1177/000313481207800815.
  • Livingston, E.H, Rege, R.V. (2004). A nationwide study of conversion from laparoscopic to open cholecystectomy. Am J Surg. 188 (3):205-211
  • Stanisic, V, Milicevic, M, Kocev, N, Stojanovic, M, Vlaovic, D, Babic, I & Vucetic, N. (2014). Prediction of difficulties in LC on the base of routinely available parameters in a smaller regional hospital. Eur Rev Med Pharmacol Sci,18 (8), 1204-11.
  • Steeg, H.J.J, Alexander, S, Houterman, S, Slooter, G.D, Roumen, R.M.H. (2011). Risk factors for conversion during LC experiences from a general teaching hospital. Scandinavian J Surg. 100:169-73
  • Sultan, A.M, El Nakeeb, A, Elshehawy, T, Elhemmaly, M, Elhanafy, E, Atef E. (2013). Risk factors for conversion during laparoscopic cholecystectomy: retrospective analysis of ten years’ experience at a single tertiary referral centre. Dig Surg 30:51–55.
  • Tazuma, S, Unno, M, Igarashi, Y, Inui, K, Uchiyama, K, Kai, M, Tsuyuguchi, T, Maguchi, H, Mori, T, Yamaguchi, K, et al. (2017). Evidence-based clinical practice guidelines for cholelithiasis 2016. J. Gastroenterol. 52:276–300. doi: 10.1007/s00535-016-1289-7.
  • Teng, Fei Yang, Lin, Guo, Qiang, Wang. (2014). Evaluation of Preoperative Risk Factor for Converting Laparoscopic to Open Cholecystectomy: A Meta Analysis. Hepatogastroenterology. Jun;61 (132):958-65.
  • Turgut, A.N.U.K, Kahramanca, Ş. (2017). Laparoskopik Kolesistektomiden Açık Kolesistektomiye Dönüşü Etkileyen Faktörler. Gümüşhane Üniversitesi Sağlık Bilimleri Dergisi, 6.3: 50-55.
  • Wolf, A.S, Nijsse, B.A, Sokalm, S.M, Chang, Y, Berger, D.L. (2009). Surgical outcomes of open cholecystectomy in the laparoscopic era. Am. J. Surg. 197:781–784. Doi 10.1016/j.amjsurg.2008.05.010.
  • Yajima, H, Kanai, H, Son, K, Yoshida, K, Yanaga, K (2014). Reasons and risk factors for intraoperative conversion from laparoscopic to open cholecystectomy. Surg Today 44:80–83.
  • Yajima, H, Kanai, H, Son, K, Yoshida, K, Yanaga, K. (2014). Reasons and risk factors for intraoperative conversion from laparoscopic to open cholecystectomy. Surg Today 44:80–83.
  • Yang, T.F, Guo, L, Wang, Q. (2014). Evaluation of Preoperative Risk Factor for Converting Laparoscopic to Open Cholecystectomy: AtaMeta-Analysis. Hepato-Gastroenterology. 61:958–965.
There are 27 citations in total.

Details

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

Recep Çağlar 0000-0003-0987-9202

Publication Date March 31, 2024
Acceptance Date November 20, 2023
Published in Issue Year 2024 Volume: 11 Issue: 1

Cite

APA Çağlar, R. (2024). Factors causing conversion in laparoscopic cholecystectomy. Sağlık Akademisyenleri Dergisi, 11(1), 37-41. https://doi.org/10.52880/sagakaderg.1287730

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