복강경 담낭절제술의 개복전환에 영향을 미치는 술 전 요인에 대한 분석
Analysis of the Preoperative Predictive Factors for Conversion from Laparoscopic to Open Cholecystectomy
금재화, 이상목, 박호철, 고석환, 오수명, 윤충, 홍성화,
소속 상세정보
금재화 ( Keum Jae-Hwa )
경희대학교 의과대학 외과학교실
이상목 ( Lee Sang-Mok )
경희대학교 의과대학 외과학교실
박호철 ( Park Ho-Chul )
경희대학교 의과대학 외과학교실
고석환 ( Koh Suck-Hwan )
경희대학교 의과대학 외과학교실
오수명 ( Oh Soo-Myung )
경희대학교 의과대학 외과학교실
윤충 ( Yoon Choong )
경희대학교 의과대학 외과학교실
홍성화 ( Hong Sung-Wha )
경희대학교 의과대학 외과학교실
KMID : 0978820030060010028
Abstract
Purpose: Laparoscopic cholecystectomy is now a standard treatment modality for symptomatic gallbladder disease. However, some proportions of laparoscopic cholecystectomy have been converted to open surgery. If risk factors for conversion from laparoscopic to open cholecystectomy could be reliably identified preoperatively, these factors would aid surgeons in preoperative patient counseling, informed consent, and operative strategy.
Methods: Medical records of 504 patients undergoing LC from 1999 to 2001 were reviewed. Demographics, history, physical examination, laboratory findings, radiology data, operative note were reviewed.
Results: Fourteen (2.8%) laparoscopic cholecystectomies required conversion to open cholecystectomy. In univariate analysis, male sex, acute cholecystitis, past history of jaundice, and elevated total bilirubin level were significant predictors. However, in multivariate analysis using logistic regression analysis, only male sex was an independent predictor for conversion to open cholecystectomy (p=0.021).
Conclusion: Most previously reported predictive factors for conversion seem to be overcome by experience of laparoscopic surgeon. Only male sex was an independent predictor for conversion to open surgery.
키워드
복강경 담낭절제술;개복전환;개복 담낭절제술;수술 전 요인
Laparoscopic cholecystectomy;Conversion;Open cholecystoctomy;Preoperative predictive factors
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