Medline ® Abstract for Reference 29
of 'Endoscopic management of bile duct stones: Standard techniques and mechanical lithotripsy'
Risk factors of open converted cholecystectomy for cholelithiasis after endoscopic removal of choledocholithiasis.
Kwon YH, Cho CM, Jung MK, Kim SG, Yoon YK
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.
Department of Internal Medicine, Kyungpook National University Medical Center, 807 Hogukno, Buk-gu, Daegu, 702-210, South Korea.