When should a surgeon think to convert laparoscopic cholecystectomy to open surgery? A Retrospective Study

Correspondence (İletişim): Ekrem Ferlengez, M.D. Saglik Bilimleri Universitesi Haseki Egitim ve Arastirma Hastanesi, Genel Cerrahi Klinigi, Istanbul, Turkey Phone (Telefon): +90 532 713 30 63 E-mail (E-posta): ekremferlengez1@yahoo.com Submitted Date (Başvuru Tarihi): 10.11. 2019 Accepted Date (Kabul Tarihi): 05.12. 2019 Copyright 2020 Haydarpaşa Numune Medical Journal OPEN ACCESS This is an open access article under the CC BY-NC license (http://creativecommons.org/licenses/by-nc/4.0/). 54 Ferlengez et al., When Should a Surgeon Think to Convert Laparoscopic Cholecystectomy to Open Surgery? / doi: 10.14744/hnhj.2019.04934 are still conversions to OC. Thus, it has become mandatory to share the possibility of conversion to OC with the patient before surgery. Moreover, it will be life-saving to use some markers to determine the patients who may undergo OC before surgery. Our aim in this study was to investigate the rates of conversion to OC in patients who have planned LC in our hospital and the preoperative parameters that can be used to evaluate this possibility and to investigate whether there is a difference between the parameters in the approach. In this way, it is to reveal the development in this field in the last ten years. Materials and Methods This study was conducted consecutively with 101 patients with elective LC with cholelithiasis between January 2015 and January 2018 at the Haseki Training and Research Hospital. The data of 50 consecutive patients who underwent OC and LC were retrospectively examined. Patients who underwent surgery and cholecystectomy were excluded from this study for another reason. Patients confirmed that their data can be used during hospitalization. Since our study was retrospective and the data consisted of standard preoperative examinations, ethics committee approval was not obtained for this study. Patients' files include age, gender, history of diabetes mellitus (DM), history of hypertension (HT), history of chronic obstructive pulmonary disease (COPD), history of acute pancreatitis, history of acute cholecystitis, endoscopic retrograde cholangiography (ERCP) history, history of abdominal surgery, number of stones in gallbladder, size of the largest stone in gallbladder, thickness of gallbladder wall, presence of pericholecystic fluid, presence of sludge in gallbladder, choledocholithiasis, leukocytes in circulating blood count, lactate dehydrogenase (LDH), aspartate aminotransferase (AST), alanine aminotransferase (ALT), gamma-glutamyl transferase (GGT), alkaline phosphatase (ALP), amylase, total bilirubin, direct bilirubin and indirect bilirubin values were recorded. Statistical Analysis In this study, mean, rate and standard deviation were used in statistics. The distribution was tested using the Kolmogorov-Smirnov test. T-test was used in the analysis of non-parametric data, and the analysis of the parametric data Mann-Whitney U test was used. In the analysis of proportional data, the chi-square test and Fischer exact test were used when chi-square conditions were not met. SPSS 19.0 program was used in the analysis.