medigraphic.com

2010, Number 1

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: Español
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.

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