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Article: Early decision for conversion of laparoscopic to open cholecystectomy for treatment of acute cholecystitis

TitleEarly decision for conversion of laparoscopic to open cholecystectomy for treatment of acute cholecystitis
Authors
Issue Date1997
PublisherElsevier Inc. The Journal's web site is located at http://www.elsevier.com/locate/amjsurg
Citation
American Journal Of Surgery, 1997, v. 173 n. 6, p. 513-517 How to Cite?
AbstractBACKGROUND: Although recent reports suggest an initial laparoscopic approach to acute cholecystitis, the risk factors and consequences of the failure of an attempt remained unknown. METHODS: A retrospective study of 557 laparoscopic cholecystectomies was undertaken to identify 70 patients (13%) with a clinical diagnosis of acute cholecystitis confirmed by ultrasonography. Patients who required conversion to laparotomy (conversion group) were compared to those with successful laparoscopic cholestectomy (successful group). RESULTS: Eight of 70 patients (11%) required conversion. The conversion group had significantly more elderly (≤65 years) patients (88% vs 37%; P = 0.02) and larger gallstones as shown on ultrasonography (25 mm vs 15.5 mm; P = 0.03). Other preoperative factors associated with severe predictive. Conversion was associated with the intraoperative finding of severe adhesions and not with those of empyema of gallbladder or gangrenous cholecystitis. Conversion was made after a median laparoscopic surgery time of 50 minutes. The conversion group required more operation time, more analgesics, a longer recovery time, and a longer hospital stay. In addition, the postoperative complication rate was significantly higher (63% vs 16%; P = 0.009). CONCLUSIONS: Patients who required conversion from laparoscopic to open cholecystectomy for acute cholecystitis are at risk for postoperative complications. In elderly patients with large gallstones, the surgeon should made an early decision to convert if severe adhesions are encountered.
Persistent Identifierhttp://hdl.handle.net/10722/83956
ISSN
2015 Impact Factor: 2.403
2015 SCImago Journal Rankings: 1.286
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorLo, CMen_HK
dc.contributor.authorFan, STen_HK
dc.contributor.authorLiu, CLen_HK
dc.contributor.authorLai, ECSen_HK
dc.contributor.authorWong, Jen_HK
dc.date.accessioned2010-09-06T08:47:13Z-
dc.date.available2010-09-06T08:47:13Z-
dc.date.issued1997en_HK
dc.identifier.citationAmerican Journal Of Surgery, 1997, v. 173 n. 6, p. 513-517en_HK
dc.identifier.issn0002-9610en_HK
dc.identifier.urihttp://hdl.handle.net/10722/83956-
dc.description.abstractBACKGROUND: Although recent reports suggest an initial laparoscopic approach to acute cholecystitis, the risk factors and consequences of the failure of an attempt remained unknown. METHODS: A retrospective study of 557 laparoscopic cholecystectomies was undertaken to identify 70 patients (13%) with a clinical diagnosis of acute cholecystitis confirmed by ultrasonography. Patients who required conversion to laparotomy (conversion group) were compared to those with successful laparoscopic cholestectomy (successful group). RESULTS: Eight of 70 patients (11%) required conversion. The conversion group had significantly more elderly (≤65 years) patients (88% vs 37%; P = 0.02) and larger gallstones as shown on ultrasonography (25 mm vs 15.5 mm; P = 0.03). Other preoperative factors associated with severe predictive. Conversion was associated with the intraoperative finding of severe adhesions and not with those of empyema of gallbladder or gangrenous cholecystitis. Conversion was made after a median laparoscopic surgery time of 50 minutes. The conversion group required more operation time, more analgesics, a longer recovery time, and a longer hospital stay. In addition, the postoperative complication rate was significantly higher (63% vs 16%; P = 0.009). CONCLUSIONS: Patients who required conversion from laparoscopic to open cholecystectomy for acute cholecystitis are at risk for postoperative complications. In elderly patients with large gallstones, the surgeon should made an early decision to convert if severe adhesions are encountered.en_HK
dc.languageengen_HK
dc.publisherElsevier Inc. The Journal's web site is located at http://www.elsevier.com/locate/amjsurgen_HK
dc.relation.ispartofAmerican Journal of Surgeryen_HK
dc.rightsThe American Journal of Surgery. Copyright © Elsevier Inc.en_HK
dc.titleEarly decision for conversion of laparoscopic to open cholecystectomy for treatment of acute cholecystitisen_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=0002-9610&volume=173&spage=513&epage=517&date=1997&atitle=Early+decision+for+conversion+of+laparoscopic+to+open+cholecystectomy+for+treatment+of+acute+cholecystitisen_HK
dc.identifier.emailLo, CM: chungmlo@hkucc.hku.hken_HK
dc.identifier.emailFan, ST: stfan@hku.hken_HK
dc.identifier.emailWong, J: jwong@hkucc.hku.hken_HK
dc.identifier.authorityLo, CM=rp00412en_HK
dc.identifier.authorityFan, ST=rp00355en_HK
dc.identifier.authorityWong, J=rp00322en_HK
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1016/S0002-9610(97)00005-6en_HK
dc.identifier.pmid9207165en_HK
dc.identifier.scopuseid_2-s2.0-0030955872en_HK
dc.identifier.hkuros24782en_HK
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-0030955872&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume173en_HK
dc.identifier.issue6en_HK
dc.identifier.spage513en_HK
dc.identifier.epage517en_HK
dc.identifier.isiWOS:A1997XG21800012-
dc.publisher.placeUnited Statesen_HK
dc.identifier.scopusauthoridLo, CM=7401771672en_HK
dc.identifier.scopusauthoridFan, ST=7402678224en_HK
dc.identifier.scopusauthoridLiu, CL=7409789712en_HK
dc.identifier.scopusauthoridLai, ECS=36932159600en_HK
dc.identifier.scopusauthoridWong, J=8049324500en_HK

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