Risk factors for conversion of laparoscopic cholecystectomy to open surgery associated with the severity characteristics according to the Tokyo guidelines

Abstract

A duration of symptoms longer than 72 h, which is included in the criterion for moderate AC severity in the TG 13, was an independent risk factor for conversion to open surgery. In addition, adoption of a high CRP value as an additional criterion for moderate AC may increase the utility of the TG 13.

Prediction of Surgical Difficulty in Laparoscopic Cholecystectomy for Acute Cholecystitis Performed Within 24 Hours After Hospital Admission

“…7,[16][17][18]20 However, the conversion rate is reported to be higher in acute cholecystitis, at 13-28%. 8,19,[21][22][23][24] This is similar to the conversion rate of 21.9% identified in our study (16 of 73 cases).…”

“…In previous reports looking at all gallbladder diseases, a number of risk factors for increased operation length and conversion rates have been established: male sex, previous history of acute cholecystitis, CRP elevation, gallbladder wall thickness, calculi, diabetes mellitus, obesity, and others. 7,[15][16][17][18] In previous studies involving only acute cholecystitis cases, Teckchandani et al 8 indicated that elevated WBC count, CRP, Alkaline phosphate, and amylase, as well as male sex, were risk factors for conversion, and Asai et al 19 identified longer presurgical symptom duration and elevated CRP as risk factors for conversion. Gallbladder thickness has been shown to be a significant predictor of laparoscopic cholecystectomy difficulty in several prior reports.…”

Outcomes of early cholecystectomy (within 7 days of admission) for acute cholecystitis according to diagnosis and severity grading by Tokyo 2013 Guideline

“…The rate of local complications (wound infection, hemorrhage, abscess etc.) and local-systemic complication rates are reported as 4.5% and 9-20.7% (10,26,28,29). Comparable with the literature, the local and systemic complication rates in our study were determined as 5% and 2%, respectively.…”

“…The conversion rate in the present study was comparable with the literature (13.4%). The risk factors for conversion were previously defined as presence of symptoms longer than 72 hr and high C reactive protein levels (>11.5) (28). In contrast, it has also been reported that duration of symptoms did not influence the rate of conversion (30).…”

Risk Factors and Predictive Models for Conversion of Laparoscopic Cholecystectomy to Open Surgery, and Surgical Quality Outcome Measures

“…AC patients have eight times higher risk of CTO than patients with uncomplicated gallstone disease (OR = 8.01; 95% CI: 6.1-10.5; P < 0.00005) [35]. Severity grades of AC, as defined by the 2013 Tokyo Guidelines, are associated with an increased rate of CTO [36,37]. The 2013 Tokyo Guidelines for severity grades of AC are shown in Table 3 [34].…”