Factores de riesgo preoperatorios asociados a conversión a técnica abierta en colecistectomía laparoscópica de urgencia

Abstract

Introduction: laparoscopic cholecystectomy is the election technique for patients with indication for gallbladder extraction. Nevertheless, near 20% of them require conversion to open surgery. In this study we evaluated preoperative risk factors for conversion in patients carried to emergency laparoscopic cholecystectomy. Metodology: a case-control unmatched study was conducted. Sociodemographic information and other interest variables were took from medical records of patients carried to surgery from 2013 to 2016. Conversion reasons were identified and study population was characterized. Correlations test were established and logistic regression was performed for evaluating the role of confounding factors. Results: we analized medical records from 444 patients (111 cases and 333 controls). Commonest conversion reason was technical difficulty (50, 5%). Older age, male sex, previous open upper abdominal surgery, Murphy sign, bile duct dilation, total white cell count > 12. 000/mm3 and more experienced surgeon, were all risk factors for conversion to open surgery. Area under COR curve was 0. 743 (CI95% 0. 692–0. 794, p= < 0. 001). Discussion: some factors increase the risk for conversion to open surgery in laparoscopic cholecystectomy. Most of them are related to an advanced gallbladder inflammation process, so extending time from symptoms beginning to surgical extraction of this organ, must be avoided.