Ann Surg Treat Res.  2016 Jun;90(6):303-308. 10.4174/astr.2016.90.6.303.

Risk factors for conversion to conventional laparoscopic cholecystectomy in single incision laparoscopic cholecystectomy

Affiliations
  • 1Department of Surgery, Konyang University Hospital, Daejeon, Korea. choiins@kyuh.ac.kr

Abstract

PURPOSE
The aim of this study was to investigate the risk factors for conversion to conventional laparoscopic cholecystectomy (CLC) in single incision laparoscopic cholecystectomy (SILC) along with the proposal for procedure selection guidelines in treating patients with benign gallbladder (GB) diseases.
METHODS
SILC was performed in 697 cases between April 2010 and July 2014. Seventeen cases (2.4%) underwent conversion to conventional LC. We compared these 2 groups and analyzed the risk factors for conversion to CLC.
RESULTS
In univariate analysis, American Society of Anesthesiologist score > 3, preoperative percutaneous transhepatic GB drainage status and pathology (acute cholecystitis or GB empyema) were significant risk factors for conversion (P = 0.010, P = 0.019 and P < 0.001). In multivariate analysis, pathology (acute cholecystitis or GB empyema) was significant risk factors for conversion to CLC in SILC (P < 0.001).
CONCLUSION
Although SILC is a feasible method for most patients with benign GB disease, CLC has to be considered in patients with acute cholecystitis or GB empyema because it is likely to result in inadequate visualization of the Calot's triangle and greater bleeding risk.

Keyword

Single incision laparoscopic; Conversion; Cholecystectomy; Risk factors

MeSH Terms

Cholecystectomy
Cholecystectomy, Laparoscopic*
Cholecystitis
Cholecystitis, Acute
Drainage
Empyema
Gallbladder
Hemorrhage
Humans
Methods
Multivariate Analysis
Pathology
Risk Factors*

Cited by  1 articles

A large-cohort comparison between single incision laparoscopic cholecystectomy and conventional laparoscopic cholecystectomy from a single center; 2080 cases
Ye-Ji Lee, Ju Ik Moon, In-Seok Choi, Sang-Eok Lee, Nak-Song Sung, Seong-Wook Kwon, Dae-Sung Yoon, Won-Jun Choi, Si-Min Park
Ann Hepatobiliary Pancreat Surg. 2018;22(4):367-373.    doi: 10.14701/ahbps.2018.22.4.367.


Reference

1. Lirici MM, Califano AD, Angelini P, Corcione F. Laparo-endoscopic single site cholecystectomy versus standard laparoscopic cholecystectomy: results of a pilot randomized trial. Am J Surg. 2011; 202:45–52.
2. Aprea G, Coppola Bottazzi E, Guida F, Masone S, Persico G. Laparoendoscopic single site (LESS) versus classic video-laparoscopic cholecystectomy: a randomized prospective study. J Surg Res. 2011; 166:e109–e112.
3. Keus F, de Jong JA, Gooszen HG, van Laarhoven CJ. Laparoscopic versus open cholecystectomy for patients with symptomatic cholecystolithiasis. Cochrane Database Syst Rev. 2006; (4):CD006231.
4. Chamberlain RS, Sakpal SV. A comprehensive review of single-incision laparoscopic surgery (SILS) and natural orifice transluminal endoscopic surgery (NOTES) techniques for cholecystectomy. J Gastrointest Surg. 2009; 13:1733–1740.
5. Navarra G, Pozza E, Occhionorelli S, Carcoforo P, Donini I. One-wound laparoscopic cholecystectomy. Br J Surg. 1997; 84:695.
6. Edwards C, Bradshaw A, Ahearne P, Dematos P, Humble T, Johnson R, et al. Single-incision laparoscopic cholecystectomy is feasible: initial experience with 80 cases. Surg Endosc. 2010; 24:2241–2247.
7. Erbella J Jr, Bunch GM. Single-incision laparoscopic cholecystectomy: the first 100 outpatients. Surg Endosc. 2010; 24:1958–1961.
8. Rivas H, Varela E, Scott D. Single-incision laparoscopic cholecystectomy: initial evaluation of a large series of patients. Surg Endosc. 2010; 24:1403–1412.
9. Hirano Y, Watanabe T, Uchida T, Yoshida S, Tawaraya K, Kato H, et al. Single-incision laparoscopic cholecystectomy: single institution experience and literature review. World J Gastroenterol. 2010; 16:270–274.
10. Lai EC, Yang GP, Tang CN, Yih PC, Chan OC, Li MK. Prospective randomized comparative study of single incision laparoscopic cholecystectomy versus conventional four-port laparoscopic cholecystectomy. Am J Surg. 2011; 202:254–258.
11. van den Boezem PB, Velthuis S, Lourens HJ, Cuesta MA, Sietses C. Single-incision and NOTES cholecystectomy, are there clinical or cosmetic advantages when compared to conventional laparoscopic cholecystectomy? A case-control study comparing single-incision, transvaginal, and conventional laparoscopic technique for cholecystectomy. World J Surg. 2014; 38:25–32.
12. Joseph M, Phillips MR, Farrell TM, Rupp CC. Single incision laparoscopic cholecystectomy is associated with a higher bile duct injury rate: a review and a word of caution. Ann Surg. 2012; 256:1–6.
13. Son JI, Choi IS, Moon JI, Ra YM, Lee SE, Choi WJ, et al. Single incision laparoscopic cholecystectomy using Konyang Standard Method. Ann Surg Treat Res. 2014; 86:177–183.
14. Sung NS, Choi IS, Moon JI, Ra YM, Lee SE, Choi WJ. Four-channel single incision laparoscopic cholecystectomy using a snake retractor: comparison between 3- and 4-channel SILC 4-channel single incision cholecystectomy. Ann Surg Treat Res. 2014; 87:81–86.
15. Langwieler TE, Nimmesgern T, Back M. Single-port access in laparoscopic cholecystectomy. Surg Endosc. 2009; 23:1138–1141.
16. Ibrahim S, Hean TK, Ho LS, Ravintharan T, Chye TN, Chee CH. Risk factors for conversion to open surgery in patients undergoing laparoscopic cholecystectomy. World J Surg. 2006; 30:1698–1704.
17. Lee JM, Kim BW, Kim WH, Wang HJ, Kim MW. Clinical implication of bile spillage in patients undergoing laparoscopic cholecystectomy for gallbladder cancer. Am Surg. 2011; 77:697–701.
18. Sato N, Yabuki K, Shibao K, Mori Y, Tamura T, Higure A, et al. Risk factors for a prolonged operative time in a single-incision laparoscopic cholecystectomy. HPB (Oxford). 2014; 16:177–182.
19. Tian YH, Ji X, Liu B, Yang GY, Meng XF, Xia HT, et al. Surgical treatment of incidental gallbladder cancer discovered during or following laparoscopic cholecystectomy. World J Surg. 2015; 39:746–752.
20. Chuang SH, Chen PH, Chang CM, Lin CS. Single-incision vs three-incision laparoscopic cholecystectomy for complicated and uncomplicated acute cholecystitis. World J Gastroenterol. 2013; 19:7743–7750.
21. Fujisaki S, Saitoh Y, Tomita R, Fukuzawa M. Laparoscopic extended cholecystectomy. J Laparoendosc Adv Surg Tech A. 2001; 11:219–222.
Full Text Links
  • ASTR
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2024 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr