engleski

Risk score and conversions to open cholecystectomy – quality assessment in Department of surgery, Clinical Hospital Centre Split

Introduction Laparoscopic cholecystectomy (LC) is the treatment of choice for symptomatic cholelithiasis. Contemporary authors worldwide claim that conversion rate to open cholecystectomy (OC) remains around 5% and somewhere up to 10%. In this retrospective study our results were evaluated by widely accepted "Risk score for conversion from laparoscopic to open cholecystectomy" (RSCLO). Methods/patients Total of 402 patients underwent LC performed by experienced laparoscopic surgeons in Department of surgery, Clinical Hospital Centre Split, in 01.01.2013. to 31.12.2013. period. Their RSCLO values were retrospectively assessed. Results There were total of 15 conversions to OC (3.73 %). Mean RSCLO value for this group was significantly higher than LC group: 13.6, 95% CI [4.2, 23.1] vs. -4.9, 95% CI [-7.2, -2.6] , p < 0.001. Intraoperative descriptors for conversion were adhesions (N=7), cholecystoenteric fistulas (N=4), choledocholithiasis found on IOCH (N=2), inadequate exposure of Calot's triangle (N=1) and other pathology – large non-biliary tumor masses in region (N=1). Additional 22 OC's were performed without attempting LC mostly because of cholecystoenteric fistulas of choledocholithiasis as well as variety of non-biliary related reasons. Conclusion High absolute value of mean RSCLO in conversion group, acceptable conversion rate and no iatrogenous injuries requiring conversion confirms quality and safety of operating procedures at our clinic.

laparoscopic cholecystectomy ; conversion ; score

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