복강경 담낭 절제술에서 개복 담낭 절제술로의 전환에 관여하는 요인들

• Published in: Annals of surgical treatment and research Vol. 63; no. 3; pp. 233 - 237
• Main Authors: 김용석(Yong Seok Kim), 장인택(In Taik Chang), 박용검(Yong Gum Park), 이정효(Jung Hyo Lee), 지경천(Kyong Choun Chi), 김상준(Sang Jun Kim)
• Format: Journal Article
• Language: Korean
• Published: 대한외과학회 01.09.2002
• Subjects: 일반외과학; 개복술로의 전환; 복강경 담낭 절제술; Laparoscopic cholecystectomy; Conversion
• ISSN: 2288-6575; 2288-6796

Purpose: Laparoscopic cholecystectomy (LC) has replaced open cholecystectomy (OC) for the majority of patients. However, a minority of patients still require conversion to open cholecystectomy during the perioperative period. This study was designed to determine the contributing factors related to conversion to open cholecystectomy. Methods: The data from 3,510 laparoscopic cholecystectomies, performed at Chung-Ang university hospital from September 1990 to June 2001, were reviewed retrospectively. Pre-operative laboratory data, post-operative pathologic findings, complications, and the reasons for conversion to open cholecystectomy were evaluated. Results: Sixty six (1.88%) of 3,510 patients were converted to open surgery, due to bleeding (39%), adhesion (26%), bile duct injury (23%) and inflammation (6%). These conversion cases were more prevalent in males and needed longer hospital stay. Thickening of the gallbladder wall and gangrenous cholecystitis were frequent pathologic findings among the conversion cases. Conclusion: Thickening of the gallbladder wall, inflammation and anatomical variation of the gallbladder were important factors for conversion to open surgery. Thus, these predictive findings allow the surgeons to preoperatively discuss the higher risk of conversion and allow for an earlier judgement and decision on conversion if intraoperative difficulty is encountered. (J Korean Surg Soc 2002;63:233- 237) KCI Citation Count: 0