Risk factors of open converted cholecystectomy for cholelithiasis after endoscopic removal of choledocholithiasis.

Abstract

BACKGROUND:

Open converted cholecystectomy could occur in patients who planned for laparoscopic cholecystectomy after endoscopic removal of choledocholithiasis.

AIM:

To evaluate the risk factors associated with open converted cholecystectomy.

PATIENTS AND METHODS:

The data for all patients who underwent cholecystectomy after endoscopic removal of choledocholithiasis were retrospectively reviewed. Factors predictive for conversion to open cholecystectomy were analyzed.

RESULTS:

The rate of open converted cholecystectomy was 15.7 %. In multivariate analysis, cholecystitis (OR 1.908, 95 % CI 1.390-6.388, p = 0.005), mechanical lithotripsy (OR 6.129, 95 % CI 1.867-20.123, p < 0.005), and two or more choledocholithiases (OR 2.202, 95 % CI 1.097-4.420, p = 0.026) revealed significant risk factors for conversion to open cholecystectomy. Analyzing the risk factors for open converted cholecystectomy according to duration from endoscopic stone removal to cholecystectomy (within 2 weeks, between 2 and 6 weeks, and beyond 6 weeks), acute cholangitis (OR 3.374, 95 % CI 1.267-8.988, p = 0.015), cholecystitis (OR 3.127, 95 % CI 1.100-8.894, p = 0.033), and mechanical lithotripsy (OR 17.504, 95 % CI 3.548-86.355, p < 0.005) were related to open converted cholecystectomy in ≤2 weeks group.

CONCLUSIONS:

For patients who need cholecystectomy after endoscopic removal of choledocholithiasis, endoscopic retrograde cholangiography-related factors predictive for open converted cholecystectomy are helpful in planning the appropriate timing of surgery.

• Authors: Yong Hwan Kwon, Chang-Min Cho, Min Kyu Jung, Sang Gul Kim, Young Kook Yoon
• Journal: Digestive diseases and sciences (Dig Dis Sci) Vol. 60 Issue 2 Pg. 550-6 (Feb 2015) ISSN: 1573-2568 [Electronic] United States
• PMID: 25228363 (Publication Type: Journal Article)

Topics

• Adult
• Aged
• Aged, 80 and over
• Chi-Square Distribution
• Cholangiopancreatography, Endoscopic Retrograde (adverse effects)
• Cholecystectomy (methods)
• Cholecystectomy, Laparoscopic
• Choledocholithiasis (diagnosis, surgery, therapy)
• Female
• Humans
• Male
• Middle Aged
• Multivariate Analysis
• Odds Ratio
• Retrospective Studies
• Risk Factors
• Time Factors
• Time-to-Treatment
• Treatment Outcome
• Young Adult