Prognostic Factors for Surgery Conversion in Acute Cholecystitis
Author Information
Author(s): Muacevic Alexander, Adler John R, Kadirvel Dhanalakshmi, Vasudevan Sreedevi, Selvamuthukumaran Sundeep, Rajput Sunidhi, Kumar Pola Govardhan
Primary Institution: Sree Balaji Medical College and Hospital, Chennai, IND
Hypothesis
Identifying prognostic factors can help predict the need for conversion from laparoscopic to open cholecystectomy in patients with acute cholecystitis.
Conclusion
Younger patients and those with lower BMI and fewer comorbidities have higher success rates for laparoscopic cholecystectomy, while older and obese patients are at greater risk of conversion to open surgery.
Supporting Evidence
- Patients aged 18-30 had a conversion rate of only 10.5%.
- Older patients (>50 years) had a conversion rate of 33.3%.
- Higher BMI (>30) was linked to increased conversions (26.3%).
- Elevated WBC and CRP levels were significant predictors of conversion.
- Gallbladder wall thickening (>4 mm) was associated with conversion rates of 20.8%.
- Converted cases had longer operative times and extended recovery periods.
- The predictive model showed a sensitivity of 88.9% and specificity of 90%.
Takeaway
This study found that younger and healthier patients do better with laparoscopic surgery for gallbladder issues, while older and heavier patients might need more complicated surgery.
Methodology
A prospective longitudinal observational study was conducted on 60 patients diagnosed with acute cholecystitis, collecting data on various prognostic factors and analyzing them using chi-squared tests.
Limitations
The study had a reduced sample size of 60 patients instead of the planned 90, which may limit the statistical power and generalizability of the findings.
Participant Demographics
Patients included were diagnosed with acute cholecystitis, with specific age and health criteria.
Digital Object Identifier (DOI)
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