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Cirujano general
versão impressa ISSN 1405-0099
Resumo
LOPEZ ESPINOSA, Guillermo; PAIPILLA MONROY, Omar Alberto; LOPEZ GOMEZ, Samantha Lucia e GONZALEZ RAMIREZ, Raúl Sergio. Identify the risk factors related to the conversion of laparoscopic cholecystectomy to open cholecystectomy in a Major Ambulatory Surgery Unit in a period of five years. Cir. gen [online]. 2020, vol.42, n.3, pp.191-196. Epub 35-Jul-2022. ISSN 1405-0099. https://doi.org/10.35366/99958.
Laparoscopic cholecystectomy has become the gold standard for the management of lithiasic cholecystitis, so knowing the risk factors for conversion to open surgery could prepare us for the strategy of surgical intervention in an ambulatory major surgery unit.
Objective:
To determine the main risk factors for the conversion of laparoscopic cholecystectomy to open cholecystectomy.
Material and methods:
Retrospective, observational study in 675 patients undergoing surgery, evaluating causes of conversion, characteristics of patients that required conversion; describing with descriptive statistics, and statistical analysis such as χ2 test and Fisher, logistic regression model for probability of conversion to open surgery.
Results:
Risk factors for conversion, males with 20.8%, p < 0.05; thickened vesicular wall 18.3%, p < 0.01; bilirubin 52.2%, p < 0.001; common bile duct 37.0%, p < 0.01; first logistic regression model, men 1.9 with p < 0.05 in the second model vesicular wall thickness 3.228 and common bile duct size 3.199 with p < 0.001.
Conclusions:
The male sex, thickened vesicular wall, dilation of common bile duct and elevated bilirubin were significant. Age, duration of the clinical picture and history of abdominal surgery, obesity and leukocytosis showed no significant statistical significance. The 2.6% conversion rate in the 5-year period is within the global statistical parameters.
Palavras-chave : Laparoscopic cholecystectomy; conversion; risk factors.
