Analysis Of Several Factors Leading To Conversion To Laparotomy During Laparoscopic Cholecystectomy

OBJECTIVE Analysis of laparoscopic cholecystectomy(Laparoscopic cholecystectomy LC)may lead to a number of risk factors for conversion to open surgery,preoperative preparation and intraoperative guidance to further reduce the rate of laparotomy.Methods The clinical data of 733 cases of laparoscopic cholecystectomy in our hospital from 2010 to were retrospectively analyzed.The risk factors related to conversion to laparotomy were retrospectively analyzedResults In our hospital 733 cases of cholecystectomy in patients with laparoscopic cholecystectomy in patients(n = 704)(n = 96%),conversion to open surgery(4%)in 29 cases.Pathological changes were confirmed in 21 cases of chronic cholecystitis,which accounted for more than 72.4%.5 cases of acute cholecystitis,accounting for more than 17.3%.3 cases of acute purulent suppurative gangrenous cholecystitis,accounting for 10.3%.The reason of conversion to laparotomy was severe tissue edema in acute stage,13 cases were difficult to organize,accounting for more than 43.3%.There were 3 cases of gallbladder neck multiple stones to the gallbladder triangle separation,accounting for more than 10%.6 cases of dense adhesions due to recurrent cholecystitis due to recurrent gallbladder triangle,accounting for more than 20%.6 cases of upper abdominal abdominal adhesion,accounting for more than 20%.Viscera transposition in 1 cases,accounting for more than 3.3%.In the conversion group single factor chi square test,male white blood cells increased,thick wall gallbladder)(4mm)and acute attack of gallbladder stone and gallbladder(72h)),elevated alanine aminotransferase,total bilirubin,diabetes,abdominal surgery history,there was statistically significant difference(P < 0.05).Age,preoperative albumin level,AST and gallstone size were significant differences(P > 0.05).In multivariate analysis found that acute gallbladder stone and gallbladder(72h)),gallbladder wall thickening(4mm)),total bilirubin,5 diabetes mellitus risk factors were independent risk factors of laparoscopic cholecystectomy(OR>1).Conclusion The risk factors of laparoscopic cholecystectomy converted to laparotomy include: gallbladder wall thickening,elevated total bilirubin,acute cholecystitis(72h),gallbladder neck stones,diabetes 5.Clinicians should carefully evaluate the preoperative risk factors,further reduction in open abdominal rate,reduce the occurrence of postoperative complications.