Molasy Bartosz, Frydrych Mateusz, Kubala-Kukus Aldona, Nieroda Kamil, Gluszek Stanislaw
Department of General Surgery, Jan Kochanowski University, Kielce, POL.
Department of General Surgery, St. Alexander Hospital, Kielce, POL.
Cureus. 2025 May 18;17(5):e84326. doi: 10.7759/cureus.84326. eCollection 2025 May.
Laparoscopic cholecystectomy is the current gold standard in the treatment of symptomatic cholecystolithiasis. The occurrence of the conversion is related to higher perioperative mortality or prolonged hospitalization. The aim of this study was to evaluate selected risk factors for conversion of laparoscopic cholecystectomy among patients undergoing surgery due to symptomatic cholelithiasis.
A retrospective analysis of patients operated on for symptomatic cholelithiasis from November 2021 to June 2023 was performed. Correlations between selected factors and the occurrence of conversion were analyzed. Early outcomes of surgical treatment and the impact of using the Enhanced Recovery After Surgery (ERAS) protocol were analyzed.
The analysis concerned 227 patients who were operated on due to symptomatic cholelithiasis. In 28 (12.3%) cases, the procedure was converted to an open method. A multivariate analysis showed that male gender (p=0.003, OR=0.196), type 2 diabetes (p=0.018, OR=4.045), older age (p=0.008, OR=1.063), and a history of acute cholecystitis (p<0.0001, OR=1.981) predispose to conversion. The occurrence of conversion is associated with the increased duration of surgery and hospitalization, a higher rate of surgical site infections, and clinically significant complications (p<0.0001). Statistically significant differences were found in the length of stay depending on the use of the ERAS protocol (p<0.0001).
The most important preoperative risk factors for conversion in the case of cholecystectomy performed due to symptomatic cholelithiasis include male gender, older age, type 2 diabetes, and a history of an episode of acute cholecystitis. The use of the ERAS protocol is safe and does not increase the conversion rate or clinically significant postoperative complications.
腹腔镜胆囊切除术是目前治疗有症状胆囊结石的金标准。中转开腹与较高的围手术期死亡率或延长住院时间有关。本研究的目的是评估因有症状胆结石接受手术的患者中转腹腔镜胆囊切除术的选定危险因素。
对2021年11月至2023年6月因有症状胆结石接受手术的患者进行回顾性分析。分析选定因素与中转开腹发生率之间的相关性。分析手术治疗的早期结果以及采用加速康复外科（ERAS）方案的影响。
分析涉及227例因有症状胆结石接受手术的患者。其中28例（12.3%）手术中转开腹。多因素分析显示，男性（p=0.003，OR=0.196）、2型糖尿病（p=0.018，OR=4.045）、高龄（p=0.008，OR=1.063）和有急性胆囊炎病史（p<0.0001，OR=1.981）易导致中转开腹。中转开腹与手术时间和住院时间延长、手术部位感染率升高以及临床显著并发症相关（p<0.0001）。根据是否采用ERAS方案，住院时间存在统计学显著差异（p<0.0001）。
因有症状胆结石行胆囊切除术时，最重要的术前中转开腹危险因素包括男性、高龄、2型糖尿病和有急性胆囊炎发作史。采用ERAS方案是安全的，不会增加中转率或临床显著的术后并发症。
