복강경 담낭 절제술에서 개복 담낭 절제술로의 전환에 관여하는 요인들
Factors for Conversion from Laparoscopic Cholecystectomy to Open Cholecystectomy
김용석, 장인택, 박용검, 이정효, 지경천, 김상준,
소속 상세정보
김용석 ( Kim Yong-Seok )
중앙대학교 의과대학 외과학교실
장인택 ( Chang In-Taek )
중앙대학교 의과대학 외과학교실
박용검 ( Park Yong-Gum )
중앙대학교 의과대학 외과학교실
이정효 ( Lee Jung-Hyo )
중앙대학교 의과대학 외과학교실
지경천 ( Chi Kyong-Chon )
중앙대학교 의과대학 외과학교실
김상준 ( Kim Sang-Jun )
중앙대학교 의과대학 외과학교실
KMID : 0371320020630030233
Abstract
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.
키워드
복강경 담낭 절제술; 개복술로의 전환
Laparoscopic cholecystectomy; Conversion
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