JaLCDOI 10.18926/AMO/55440
FullText URL 71_5_419.pdf
Author Utsumi, Masashi| Aoki, Hideki| Kunitomo, Tomoyoshi| Mushiake, Yutaka| Yasuhara, Isao| Taniguchi, Fumitaka| Arata, Takashi| Katsuda, Koh| Tanakaya, Kohji| Takeuchi, Hitoshi|
Abstract To identify predictive factors for conversion from laparoscopic cholecystectomy (LC) to open cholecystectomy performed for mixed indications as an acute or elective procedure. We retrospectively analyzed the data of 236 consecutive cases of LC performed in our department between January 2012 and January 2015, and evaluated preoperative risk factors for conversion and the usefulness of the 2013 Tokyo guidelines (TG2013) for diagnosing acute cholecystitis. The conversion rate in our series was 8% (19/236 cases). The following independent predictive factors of conversion were identified (p≤0.04): previous upper abdominal surgery (odds ratio (OR), 14.6), pericholecystic fluid (OR, 10.04), acute cholecystitis (OR, 7.81), and emergent LC (OR, 15.8). Specifically for patients with acute cholecystitis defined using the 2013 Tokyo guidelines, use of an antiplatelet or anticoagulant drug for cardiovascular disease (p=0.043), previous upper abdominal surgery (p<0.031) and a resident as operator (p=0.041) were predictive factors. The risk factors for conversion identified herein could help to predict the difficulty of the procedure and could be used by surgeons to better inform patients regarding the risks for conversion. The TG2013 can be an effective tool for diagnosing acute cholecystitis to make informed clinical decisions regarding the optimal procedure for a patient.
Keywords laparoscopic cholecystectomy conversion risk factors acute cholecystitis Tokyo guidelines 2013
Amo Type Original Article
Published Date 2017-10
Publication Title Acta Medica Okayama
Volume volume71
Issue issue5
Publisher Okayama University Medical School
Start Page 419
End Page 425
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language 英語
Copyright Holders CopyrightⒸ 2017 by Okayama University Medical School
File Version publisher
Refereed True
PubMed ID 29042700