Haydarpasa Numune Med J. 2020; 60(1): 53-59 | DOI: 10.14744/hnhj.2019.04934

When Should a Surgeon Think to Convert Laparoscopic Cholecystectomy to Open Surgery? A Retrospective Study

Ekrem Ferlengez¹, Serap Pamak Bulut^2
1Department of General Surgery, University of Health Science Haseki Training and Research Hospital, Istanbul, Turkey
²University of Health Science Hamidiye Vocational School of Health Services, Istanbul, Turkey

INTRODUCTION: Today, it is still a difficult decision for surgeons to convert from laparoscopic cholecystectomy (LC) to Open cholecystectomy (OC). Our aim in this study is to predict the possibility of conversion to OC before the operation by comparing the data of the patients who underwent LC.
METHODS: Patients were divided into two groups. The first group was the OC group and the second group was the LC group. The data of both groups were compared with various parameters.
RESULTS: The conversion rate from LC to OC was 7.2%. The rate of conversion in male patients was 12.8%, and the rate of conversion in female patients was 5.2%. The mean age of the group with OC (52.66±13.77) was statistically higher (p=0.019 <0.05) than the laparoscopy group (47.22±13.04).

DISCUSSION AND CONCLUSION: Regarding patients’ age, gender, increased alkaline phosphatase, gamma-glutamyl transferase and direct bilirubin values, gallbladder wall thickness, presence of bile sludge and presence or suspicion of choledocholithiasis, preoperative endoscopic retrograde cholangiography history parameters as a risk factor in the group OC, there were statistically significant relation.

Keywords: Conversion, laparoscopic cholecystectomy; open cholecystectomy.

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Bir cerrah laparoskopik kolesistektomiden açýk cerrahiye geçiþi ne zaman düþünmeli? Retrospektif Çalýþma

Ekrem Ferlengez¹, Serap Pamak Bulut^2
1Saðlýk Bilimleri Üniversitesi Haseki Eðitim Ve Araþtýrma Hastanesi Genel Cerrahi Kliniði, Ýstanbul, Türkiye
²Saðlýk Bilimleri Üniversitesi Hamidiye Saðlýk Hizmetleri Meslek Okulu, Ýstanbul, Türkiye

GÝRÝÞ ve AMAÇ: Günümüzde cerrahlarýn laparoskopik kolesistektomiden (LC) Açýk kolesistektomiye (OC) geçmeleri hala zor bir karardýr. Bu çalýþmada amacýmýz LC yapýlan hastalarýn verilerini karþýlaþtýrarak ameliyat öncesi OC'ye dönüþüm olasýlýðýný öngörmektir.
YÖNTEM ve GEREÇLER: Hastalar iki gruba ayrýldý. Ýlki OC grubuydu. Ýkincisi LC grubu iken. Her iki grubun verileri çeþitli parametrelerle karþýlaþtýrýldý.
BULGULAR: LC'den OC'ye dönüþüm oraný %7,2 idi. Erkek hastalarda dönüþüm oraný %12.8, kadýn hastalarda ise %5.2 idi. OC'li grubun ortalama yaþý (52.66 ± 13.77) istatistiksel olarak laparoskopi grubundan (47.22 ±13.04) daha yüksekti (p=0.019 < 0.05).
TARTIÞMA ve SONUÇ: Hastalarýn yaþý, cinsiyeti, artmýþ alkalen fosfataz, gama-glutamil transferaz ve direkt bilirubin deðerleri, safra kesesi duvar kalýnlýðý, safra çamuru varlýðý ve koledokolitiyazis varlýðý veya þüphesi, preoperatif endoskopik retrograd kolanjiyografi öykü parametreleri grup OC'de risk faktörü olarak istatistiksel olarak anlamlý bulundu.

Anahtar Kelimeler: Açýða geçiþ, laparoskopik kolesistektomi, açýk kolesistektomi.

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