Comparative Clinical Analysis of 111 Cases Conversed to Open Procedure During Laparoscopic Cholecystectomy of 2,523 Cases

PURPOSE: While laparoscopic cholecystectomy is successfully performed on majority of patients, conversion to open procedure is yet necessary in certain cases in the perioperative period. The purpose of this study is to identify the discerning factors that help determine the conversion into open cholecystectomy.

METHOD: A retrospective review was conducted on the data of 2,523 laparoscopic cholecystectomies performed at Chung-Ang University Hospital from January 2002 to July 2007. Patients¡¯ sex, age, height, weight, BMI (Body Mass Index), duration of preoperative hospital stay, preoperative physical examination, laboratory data, radiologic findings, and the reason for conversion to open procedure were evaluated.

RESULTS: Adhesion was perceived to be the most critical factor for conversion shown in 50.5% (n=56) out of total 111 cases. Bleeding (22.5%), bile duct injury (11.7%), inflammation (9.0%), and uncertain anatomy (6.3%) were followed sequentially. By univariate analysis, factors found to increase significantly the risk of conversion were patient age >70 years, male sex, previous abdominal operation, preoperative common bile duct stone, tenderness in right upper quadrant, distended shape of gallbladder, and pericholecystic fluid collection. From multivariate analysis, the following factors were identified to be associated with a higher risk: patient age >70 years (p=0.002), male sex (p=0.012), previous abdominal operation (p


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Program Number: P408

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