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Risk Factors of Open Converted Cholecystectomy for Cholelithiasis After Endoscopic Removal of Choledocholithiasis

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Abstracts

Background

Open converted cholecystectomy could occur in patients who planned for laparoscopic cholecystectomy after endoscopic removal of choledocholithiasis.

Aim

To evaluate the risk factors associated with open converted cholecystectomy.

Patients and Methods

The data for all patients who underwent cholecystectomy after endoscopic removal of choledocholithiasis were retrospectively reviewed. Factors predictive for conversion to open cholecystectomy were analyzed.

Results

The rate of open converted cholecystectomy was 15.7 %. In multivariate analysis, cholecystitis (OR 1.908, 95 % CI 1.390–6.388, p = 0.005), mechanical lithotripsy (OR 6.129, 95 % CI 1.867–20.123, p < 0.005), and two or more choledocholithiases (OR 2.202, 95 % CI 1.097–4.420, p = 0.026) revealed significant risk factors for conversion to open cholecystectomy. Analyzing the risk factors for open converted cholecystectomy according to duration from endoscopic stone removal to cholecystectomy (within 2 weeks, between 2 and 6 weeks, and beyond 6 weeks), acute cholangitis (OR 3.374, 95 % CI 1.267–8.988, p = 0.015), cholecystitis (OR 3.127, 95 % CI 1.100–8.894, p = 0.033), and mechanical lithotripsy (OR 17.504, 95 % CI 3.548–86.355, p < 0.005) were related to open converted cholecystectomy in ≤2 weeks group.

Conclusions

For patients who need cholecystectomy after endoscopic removal of choledocholithiasis, endoscopic retrograde cholangiography-related factors predictive for open converted cholecystectomy are helpful in planning the appropriate timing of surgery.

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Conflict of interest

Yong Hwan Kwon, Min Kyu Jung, Chang-Min Cho, Sang Gul Kim, Young Kook Yoon have no conflicts of interest or financial ties to disclose.

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Authors and Affiliations

  1. Department of Internal Medicine, Kyungpook National University Medical Center, 807 Hogukno, Buk-gu, Daegu, 702-210, South Korea

    Yong Hwan Kwon, Chang-Min Cho & Min Kyu Jung

  2. Department of Surgery, Kyungpook National University Medical Center, Daegu, South Korea

    Sang Gul Kim & Young Kook Yoon

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  1. Yong Hwan Kwon
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  2. Chang-Min Cho
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  3. Min Kyu Jung
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  4. Sang Gul Kim
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Correspondence to Chang-Min Cho.

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Kwon, Y.H., Cho, CM., Jung, M.K. et al. Risk Factors of Open Converted Cholecystectomy for Cholelithiasis After Endoscopic Removal of Choledocholithiasis. Dig Dis Sci 60, 550–556 (2015). https://doi.org/10.1007/s10620-014-3337-6

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  • DOI: https://doi.org/10.1007/s10620-014-3337-6

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