Yusuf TANRIKULU, Beslen GÖKSOY, Gökhan YILMAZ

Physio-pathological risk factors from gallbladder affectingthe conversion from laparoscopic cholecystectomy toopen cholecystectomy

Aim: Laparoscopic cholecystectomy is the first-line treatment method in the surgical treatment of gallbladder pathologies. Predictingconversion from laparoscopic to open cholecystectomy is still an important problem in the world. In our study, we aimed to investigatethe gallbladder-derived physiopathological risk factors that affect the conversion from laparoscopic to open cholecystectomy. Materials and Methods: 370 patients who underwent cholecystectomy with the indications of symptomatic gallstone, acutecholecystitis, asymptomatic gallstones and gallbladder polyps were included in the study. Patients' demographic data such as ageand sex, and pathological diagnoses, gallbladder wall thickness, and gallbladder volumes were obtained from pathology results. Theeffects of physiological parameters on conversion to open cholecystectomy were compared. Results: The most common indication for surgery is symptomatic gallstones (227 patients, 74.9%). The first preferred surgicaltechnique is laparoscopic cholecystectomy with 86.5%. The conversion rate was 10.5% (n=39). The rate of conversion to opencholecystectomy was found to be high and a statistically significant difference was observed in patients with high gallbladder wallthickness and large sac volume (p

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1. Goonawardena J, Gunnarsson R, de Costa A. Predicting conversion from laparoscopic to open cholecystectomy presented as a probability nomogram based on preoperative patient risk factors. Am J Surg 2015;210:492-500.
2. Rosen M, Brody F, Ponsky J. Predictive factors for conversion of laparoscopic cholecystectomy. Am J Surg. 2002;184:254-8.
3. Lipman JM, Claridge JA, Haridas M, et al. Preoperative findings predict conversion from laparoscopic to open cholecystectomy. Surgery 2007;142:556-63.
4. Ballal M, David G, Willmott S, Corless DJ, Deakin M, Slavin JP. Conversion after laparoscopic cholecystectomy in England. Surg Endosc 2009;23:2338-44.
5. Ishizaki Y, Miwa K, Yoshimoto J, Sugo H, Kawasaki S. Conversion of elective laparoscopic to open cholecystectomy between 1993 and 2004. Br J Surg 2006;93:987-91.
6. Kama NA, Kologlu M, Doganay M, Reis E, Atli M, Dolapci M. A risk score for conversion from laparoscopic to open cholecystectomy. Am J Surg 2001;181:520-5.
7. Sippey M, Grzybowski M, Manwaring ML, et al. Acute cholecystitis: risk factors for conversion to an open procedure. J Surg Res 2015;199:357-61.
8. Vivek MA, Augustine AJ, Rao R. A comprehensive predictive scoring method for difficult laparoscopic cholecystectomy. J Minim Access Surg 2014;10:62-7.
9. Stanisic V, Andjelkovic I, Vlaovic D, et al. Feasibility of applying data mining techniques for predicting technical difficulties during laparoscopic cholecystectomy based on routine patient work-up in a small community hospital. Hepatogastroenterology 2013;60:1561-8.
10. Kaafarani HM, Smith TS, Neumayer L, et al. Trends, outcomes, and predictors of open and conversion to open cholecystectomy in Veterans Health Administration hospitals. Am J Surg 2010;200:32-40.
11. Randhawa JS, Pujahari AK. Preoperative prediction of difficult lap chole: a scoring method. Indian J Surg 2009;71:198-201.
12. Zehetner J, Leidl S, Wuttke ME, et al. Conversion in Laparoscopic Cholecystectomy in Low Versus Highvolume Hospitals Is there a Difference? Surg Laparosc Endosc Percutan Tech 2010;20:173-6.
13. Hu ASY, Menon R, Gunnarsson R, et al. Risk factors for conversion of laparoscopic cholecystectomy to open surgery - A systematic literature review of 30 studies. Am J Surg 2017;214:920-30.
14. Gholipour C, Fakhree MB, Shalchi RA, et al. Prediction of conversion of laparoscopic cholecystectomy to open surgery with artificial neural networks. BMC Surg. 2009;9:13.
15. Zhang WJ, Li JM, Wu GZ, et al. Risk factors affecting conversion in patients undergoing laparoscopic cholecystectomy. ANZ J Surg 2008;78:973-6.
16. Yajima H, Kanai H, Son K, et al. Reasons and risk factors for intraoperative conversion from laparoscopic to open cholecystectomy. Surg Today 2014;44:80-3.
17. Sultan AM, El Nakeeb A, Elshehawy T, et al. Risk factors for conversion during laparoscopic cholecystectomy: retrospective analysis of ten years' experience at a single tertiary referral centre. Dig Surg. 2013;30:51-5.
18. Lujan JA, Sanchez-Bueno F, Parrilla P, et al. Laparoscopic vs. open cholecystectomy in patients aged 65 and older. Surg Laparosc Endosc. 1998;8:208- 10.
19. El-Gendi A, El-Shafei M, Emara D. Emergency Versus Delayed Cholecystectomy After Percutaneous Transhepatic Gallbladder Drainage in Grade II Acute Cholecystitis Patients. J Gastrointest Surg 2017;21:284.
20. Lipman JM, Claridge JA, Haridas M, et al. Preoperative findings predict conversion from laparoscopic to open cholecystectomy. Surgery 2007;142:556-63.
21. Kaafarani HM, Smith TS, Neumayer L, et al. Trends, outcomes, and predictors of open and conversion to open cholecystectomy in Veterans Health Administration hospitals. Am J Surg 2010;200:32-40.
22. Russell JC, Walsh SJ, Fourquet LR, et al. Symptomatic cholelithiasis: a different disease in men? Ann Surg 1998;277:195-200
23. Randhawa JS, Pujahari AK. Preoperative prediction of difficult lap chole: a scoring method. Indian J Surg 2009;71:198-201.