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Medline ® Abstract for Reference 29

of 'Endoscopic management of bile duct stones: Standard techniques and mechanical lithotripsy'

29
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Risk factors of open converted cholecystectomy for cholelithiasis after endoscopic removal of choledocholithiasis.
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Kwon YH, Cho CM, Jung MK, Kim SG, Yoon YK
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Dig Dis Sci. 2015 Feb;60(2):550-6. Epub 2014 Sep 17.
 
BACKGROUND: Open converted cholecystectomy could occur in patients who planned for laparoscopic cholecystectomy after endoscopic removal of choledocholithiasis.
AIM: To evaluate the risk factors associated with open converted cholecystectomy.
PATIENTS AND METHODS: The data for all patients who underwent cholecystectomy after endoscopic removal of choledocholithiasis were retrospectively reviewed. Factors predictive for conversion to open cholecystectomy were analyzed.
RESULTS: The rate of open converted cholecystectomy was 15.7 %. In multivariate analysis, cholecystitis (OR 1.908, 95 % CI 1.390-6.388, p = 0.005), mechanical lithotripsy (OR 6.129, 95 % CI 1.867-20.123, p<0.005), and two or more choledocholithiases (OR 2.202, 95 % CI 1.097-4.420, p = 0.026) revealed significant risk factors for conversion to open cholecystectomy. Analyzing the risk factors for open converted cholecystectomy according to duration from endoscopic stone removal to cholecystectomy (within 2 weeks, between 2 and 6 weeks, and beyond 6 weeks), acute cholangitis (OR 3.374, 95 % CI 1.267-8.988, p = 0.015), cholecystitis (OR 3.127, 95 % CI 1.100-8.894, p = 0.033), and mechanical lithotripsy (OR 17.504, 95 % CI 3.548-86.355, p<0.005) were related to open converted cholecystectomy in≤2 weeks group.
CONCLUSIONS: For patients who need cholecystectomy after endoscopic removal of choledocholithiasis, endoscopic retrograde cholangiography-related factors predictive for open converted cholecystectomy are helpful in planning the appropriate timing of surgery.
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Department of Internal Medicine, Kyungpook National University Medical Center, 807 Hogukno, Buk-gu, Daegu, 702-210, South Korea.
PMID