The severity grading of acute cholecystitis following the Tokyo Guidelines is the most powerful predictive factor for conversion from laparoscopic cholecystectomy to open cholecystectomy

The relationship between the severity assessment of acute cholecystitis based on the Tokyo Guidelines and the risk for conversion from laparoscopic surgery to open surgery has been assessed in few previous reports, with conflicting results. A retrospective review of patients with acute cholecystitis...

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Vydané v:Journal of visceral surgery Ročník 154; číslo 4; s. 239 - 243
Hlavní autori: Bouassida, M., Chtourou, M.F., Charrada, H., Zribi, S., Hamzaoui, L., Mighri, M.M., Touinsi, H.
Médium: Journal Article
Jazyk:English
Vydavateľské údaje: France Elsevier Masson SAS 01.09.2017
Predmet:
Acute cholecystitis
Adult
Aged
Aged, 80 and over
Cholecystectomy, Laparoscopic
Cholecystitis, Acute - diagnosis
Cholecystitis, Acute - surgery
Conversion
Conversion to Open Surgery - statistics & numerical data
Female
Humans
Laparoscopy
Male
Middle Aged
Multivariate Analysis
Retrospective Studies
Risk Factors
Severity of Illness Index
Conversion
Acute cholecystitis
Laparoscopy
ISSN:1878-7886, 1878-7886
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Shrnutí:The relationship between the severity assessment of acute cholecystitis based on the Tokyo Guidelines and the risk for conversion from laparoscopic surgery to open surgery has been assessed in few previous reports, with conflicting results. A retrospective review of patients with acute cholecystitis within a single system from 2010 to 2013 was performed. The diagnosis and severity of acute cholecystitis were assigned by the Tokyo Guidelines 2013 (TG13). The primary outcome measure was conversion to open cholecystectomy. During the period of study, 493 patients were operated by laparoscopy for acute cholecystitis. Laparoscopic cholecystectomy was intraoperatively converted to open surgery in 56 cases (11.4%). The multivariate analysis showed that the risk factors for conversion to open surgery included male gender (OR: 2.15; IC95% [1.18–3.9]), diabetes (OR: 2.22; IC95% [1.13–4.33]), total bilirubin levels (OR: 1.02; IC95% [1–1.05]), and the TG13 severity classification (OR: 4.44; IC95% [2.25–8.75]). The independent risk factors for conversion to open surgery included male sex, diabetes mellitus, total bilirubin level, and TG13 grade. TG13 grade was found to be the most powerful predictive factor for conversion as it had the highest OR.
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ISSN:1878-7886
1878-7886
DOI:10.1016/j.jviscsurg.2016.11.007