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Revista Colombiana de Cirugía
versão impressa ISSN 2011-7582versão On-line ISSN 2619-6107
Resumo
ENSUNCHO-HOYOS, César Rafael; NEGRETE-SPATH, Carolina Isabel e RODRIGUEZ-PADILLA, Libia María. Factors associated with conversion to open technique in laparoscopic cholecystectomy. rev. colomb. cir. [online]. 2023, vol.38, n.4, pp.666-676. Epub 15-Jul-2023. ISSN 2011-7582. https://doi.org/10.30944/20117582.2305.
Introduction.
Laparoscopic cholecystectomy is the gold standard for the management of gallbladder pathology with surgical indication. During its execution, there is a group of patients who may require conversion to the open technique. This study evaluated perioperative factors associated with conversion at the OHL Central Clinic in Montería, Colombia.
Methods.
Observational analytical case-control study nested in a retrospective cohort between 2018 and 2021, in a 1:3 case/control ratio, 95% confidence level and 90% power. The study population was characterized and the associations were evaluated according to the nature of the variables, then the OR were estimated by bivariate and multivariate analysis, with their 95% CI, considering a value of p<0.05 significant, controlling for confounding variables.
Results.
The study included 332 patients, 83 cases and 249 controls, showing in the multivariate model that the variables most strongly associated with conversion were: the surgeon’s experience (p=0.001), obesity (p=0.036), gallbladder wall thickening on ultrasonography (p=0.011), and a higher score in the Parkland classification (p<0.001).
Conclusions.
Early identification and individual analysis of the perioperative risk factors for conversion in the planning of laparoscopic cholecystectomy could define which patients are exposed, and which could benefit from a minimally invasive approach, in search of making safe, cost-effective, and appropriate decisions.
Palavras-chave : laparoscopic cholecystectomy; cholelithiasis; acute cholecystitis; risk factors; postoperative complications; conversion to open surgery.