medigraphic.com
ISSN 2594-1518 (Electronic)
ISSN 1405-0099 (Print)

2010, Number 1

<< Back Next >>

Cir Gen 2010; 32 (1)

Risk factors for conversions from laparoscopic cholecystectomy to open cholecystectomy

Prieto-Díaz-Chávez E, Medina-Chávez JL, Anguiano-Carrazco JJ, Trujillo-Hernández B

Language: Spanish
References: 16
Page: 34-38
PDF size: 107.87 Kb.


ABSTRACT

Objective: To identify the risk factors related with the conversion of laparoscopic cholecystectomy to open surgery.
Setting: General Zone Hospital No. 1, Instituto Mexicano del Seguro Social
Design: Cross-sectional analytical study.
Statistical analysis: Averages, standard deviations, Student’s t test, Chi square test, and logistic regression analysis.
Material and Methods: Patients subjected to laparoscopic cholecystectomies from January 2004 to January 2005 and with complete clinical records were analyzed. We evaluated the variables related to their demographic characteristics and to the surgical event.
Results: We studied 120 patients, average age of 48 ± 20, 3 men and 117 women, finding conversion to open surgery in 2.5% of cases. Risk factors with statistical significance in the univariate analysis were antecedents of diabetes mellitus, alithiasic cholecystitis, technical difficulty, anatomical doubt at the time of dissection, and, finally, transoperative hemorrhage. Multivariate analysis revealed that the significant factors for conversion were technical difficulty and anatomical doubt at the time of dissection (RR 118. p ›0.0001) and transoperative hemorrhage (RR 59.5, p ›0.0001).
Conclusions: Identifying clearly the risk factors associated to conversions in surgery contributes to an excellent planning, improvement in the waiting time for a hospital bed, lower costs, planning of the duration of convalescence, and, above all, satisfaction of the patient.


REFERENCES

  1. Ortiz de la Peña-Rodríguez J, Orozco-Obregón P, De la Fuente-Lira M. Reporte de 604 casos de colecistectomías por laparoscopia manejados por un mismo equipo quirúrgico. Rev Mex Cir Endoscop 2002; 3: 16-19.

  2. Wallace DH, Serpell MG, Baxter JN, O´Dwyer PJ. Randomized trial of different insuflation pressures for laparoscopic cholecystectomy. Br J Surg 1997; 84: 455-458.

  3. Bueno J, Serralta A, Planells M, Poups S, Ballester C, Ibáñez F, et al. Colecistectomía laparoscópica y sus complicaciones: nuestra experiencia en nueve años. Cir Esp 2001; 69: 467-472.

  4. Clarke JR, Malet PF, Staroscik RN, Schwartz S, Williams SV. Mortality and complications associated with laparoscopic cholecystectomy. A meta-analysis. Ann Surg 1996; 224: 609-620.

  5. Pérez-Castro E, Ostos-Mondragón LJ, Mejía-Damián AF, García-Feregrino MC. Colecistectomía laparoscópica ambulatoria. Rev Med IMSS 2002; 40: 71-75.

  6. Bermúdez-Pestonit I, López-Álvarez S, Sanmillán-Álvarez A, González-Nisarre C, Baamonde-de-la-Torre I, Rodríguez-Vila A, et al. Colecistectomía laparoscópica en régimen ambulatorio. Cir Esp 2004; 76: 159-163.

  7. Fleisher LA, Yee K, Lillemoe KD, Talamini MA, Yeo CJ, Heath RR, et al. Is outpatient laparoscopic cholecystectomy safe and cost-effective? A model to study transition of care. Anesthesiology 1999; 90: 1746-1755.

  8. Paredes JP, Puñal JA, Beiras A, Barreiro F, Segade FR, Martínez J, et al. Mil colecistectomías laparoscópicas: indicaciones y resultados. Cir Esp 2001; 70: 195-199.

  9. González-Ruiz V, López-López J, Higuera-Hidalgo FR, López-Loredo A, Rico-Hinojosa M, Rodríguez-Martínez J. Colecistectomía laparoscópica en un hospital público. Cir Gral 2007; 29: 131-135.

  10. Rodríguez-González HJ. Colecistectomía laparoscópica. experiencia en un hospital de tercer nivel de atención. Cir Gral 2006; 28: 219-224.

  11. Rosen M, Malm JA, Tarnoff M, Zuccala K, Ponsky J. Cost-effectiveness of ambulatory laparoscopic cholecystectomy. Surg Laparosc Endosc Percutan Tech 2001; 11: 182–184.

  12. Quilici PJ. Colecistectomía laparoscópica. Clin de End de North Am 1993; 2: 219.

  13. Alponat A, Kum CK, Koh BC, Rajnakova AG. Predictive factors for conversion of laparoscopic cholecystectomy. World J Surg 1997; 21: 629-33.

  14. Liu CL, Fan ST, Lai EC, Lo C M, Chu, K M. Factors affecting conversion of laparoscopic cholecystectomy to open surgery. Arch Surg 1996; 131: 98-101.

  15. Rattner DW, Ferguson C, Warshaw AL. Factors associated with successful laparoscopic cholecystectomy for acute cholecystitis. Ann Surg 1993; 217: 233-6.

  16. Sanabria JR, Gallinger S, Croxford R, Strasberg SM. Risk factors in elective laparoscopic cholecystectomy for conversion to open cholecystectomy. J Am Coll Surg 1994; 179: 696-704.




2020     |     www.medigraphic.com