Analysis of the risk factors and prognosis of conversion to open laparotomy of laparoseopic cholecystectomy for acute cholecystitis

Abstract

Objective To investigate the risk factors and prognosis of conversion to open laparotomy of laparoseopic cholecystectomy for acute cholecystitis. Methods The clinical data of 231 patients from March 2014 to July 2017 who were diagnosed as acute cholecystitis and treated with LC were collected and analyzed. According to whether conversion to open laparotomy, the patients were divided into LC group (205 cases) and open laparotomy group (26 cases). The clinical data were analyzed and compared with Stata 14.1 statistical software. T test was used for the analysis of quantitative data. Counting data single factor analysis was adopted by chi-square test. The Logistic regression model was used to analyze the risk factors of LC transshipment, and the ROC curve was fitted. In this study, P<0.05 was considered to be statistically significant. Results Single factor analysis showed that BMI, duration, thickness of gallbladder wall and white blood cell count were associated with conversion to open laparotomy of LC. Multifactorial Logistic regression analysis showed that: BMI (OR=1.407, P=0.000), white blood cell count (OR=1.600, P=0.003), alkaline phosphatase (OR=1.042, P=0.000) were the independent risk factors; No serious complications were observed in the open laparotomy group. Conclusion The operation physician should evaluate the physical condition, white blood cell level, alkaline phosphatase and other conditions of the patients before LC operation, so as to reduce the rate of conversion to open laparotomy. Key words: Cholecystitis, Acute; Laparotomy; Risk Factors