Johanning J M, Gruenberg J C
JSLS. 1997 Apr-Jun;1(2):181-3.
To examine and classify the reasons for conversion and the points at which laparoscopic cholecystectomies are converted to open procedures and whether these change over time.
This is a retrospective study of all patients undergoing cholecystectomy from June 1, 1990 to June 30, 1995. Reasons for conversion were classified using the "AEIOU:ABC" system developed for this study and conversion points were assigned chronologically.
The "AEIOU:ABC" classification system was utilized. The most common reasons for conversion were: acute inflammation N = 61 (26.1%); adhesions N = 51 (21.8%); and organ system pathology N = 39 (16.7%). The most common conversion points were; after visualization of the peritoneal cavity but prior to dissection of the cystic structures N = 103 (44.0%); dissection of the cystic structures N = 58 (24.8%); initial laparoscopy N = 36 (15.4%). When the reasons for conversion were evaluated for changes over time there was no statistically significant change for the total group or any individual surgeon. Conversion points did not change with increasing operative experience.
The "AEIOU:ABC" classification system is a simple, effective and easy to use system for classifying the myriad of reasons for conversion. The system needs to be validated prospectively not only for laparoscopic cholecystectomy but for possible application to other laparoscopic procedures.
研究并分类腹腔镜胆囊切除术中转开腹手术的原因、中转时间点，以及这些因素是否随时间变化。
这是一项对1990年6月1日至1995年6月30日期间所有接受胆囊切除术患者的回顾性研究。采用为本研究开发的“AEIOU:ABC”系统对中转原因进行分类，并按时间顺序确定中转点。
采用了“AEIOU:ABC”分类系统。最常见的中转原因是：急性炎症N = 61例（26.1%）；粘连N = 51例（21.8%）；器官系统病变N = 39例（16.7%）。最常见的中转点是：在观察到腹膜腔后但在解剖胆囊结构之前N = 103例（44.0%）；解剖胆囊结构时N = 58例（24.8%）；初次腹腔镜检查时N = 36例（15.4%）。在评估中转原因随时间的变化时，总体组或任何个体外科医生均无统计学上的显著变化。中转点并未随着手术经验的增加而改变。
“AEIOU:ABC”分类系统是一种简单、有效且易于使用的系统，用于对多种中转原因进行分类。该系统不仅需要在前瞻性研究中针对腹腔镜胆囊切除术进行验证，还可能适用于其他腹腔镜手术。
