Chapter 3
Risk Factors and Predictive Models for Conversion of
Laparoscopic Cholecystectomy to Open Surgery, and
Surgical Quality Outcome Measures
Andrei M. Beliaev and Michael Booth
Additional information is available at the end of the chapter
http://dx.doi.org/10.5772/63648
AbstractBackground: Laparoscopic cholecystectomy is the preferred surgical operation for
symptomatic gallstone disease. Conversion of laparoscopic cholecystectomy to open
surgery is used to prevent intra-abdominal organ injury, for open common bile duct
exploration and to repair intra-abdominal organ injury.
Objective: The objective of this chapter is to review risk factors and predictive models
for conversion of laparoscopic cholecystectomy to open surgery, and surgical quality
outcome measures.
Methods: A narrative literature review using Pubmed, Medline, Cochrane library
databases and Google search engine is described.
Results: From the literature review, patient- and surgeon-related risk factors and
predictive models for conversion of laparoscopic cholecystectomy to open surgery
were identified. Patient-dependent risk factors included preoperative and intraoper‐
ative variables. Current conversion of laparoscopic cholecystectomy to open surgery
predictive models use only patient-dependent risk factors and were not tested on an
independent sample of patients. Surgical quality outcome measures incorporate an
association between conversion and intra-abdominal organ injury that demonstrates
that conversion was used as an emergency strategy to repair injuries rather than a
safety measure.
Conclusion: Conversion of laparoscopic cholecystectomy to open surgery risk
stratification based on patient- and surgeon-dependent variables may allow a better
management of the patient to keep conversion at low rates and to maintain benefits
of minimally invasive surgery.