Laparoscopic cholecystectomy is a standard treatment for cholelithiasis. In situations where laparoscopic cholecystectomy is dangerous, a surgeon may be forced to change from laparoscopy to an open procedure. Data from the literature shows that 2 to 15% of laparoscopic cholecystectomies are converted to open surgery during surgery for various reasons. The aim of this study was to identify the risk factors for the conversion of laparoscopic cholecystectomy to open surgery. A retrospective analysis of medical records and operation protocols was performed. The study group consisted of 263 patients who were converted into open surgery during laparoscopic surgery, and 264 randomly selected patients in the control group. Conversion risk factors were assessed using logistic regression analysis that modeled the probability of a certain event as a function of independent factors. Statistically significant factors in the regression model with all explanatory variables were age, emergency treatment, acute cholecystitis, peritoneal adhesions, chronic cholecystitis, and inflammatory infiltration. The use of predictive risk assessments or nomograms can be the most helpful tool for risk stratification in a clinical scenario. With such predictive tools, clinicians can optimize care based on the known risk factors for the conversion, and patients can be better informed about the risks of their surgery.

中文翻译：

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腹腔镜胆囊切除术转为开腹胆囊切除术的危险因素分析

腹腔镜胆囊切除术是胆石症的标准治疗方法。在腹腔镜胆囊切除术有危险的情况下，可能会迫使外科医生从腹腔镜手术改为开放手术。来自文献的数据表明，出于各种原因，在手术期间有2％到15％的腹腔镜胆囊切除术被转换为开放手术。这项研究的目的是确定将腹腔镜胆囊切除术转换为开放手术的危险因素。回顾性分析病历和手术方案。研究组由263例在腹腔镜手术中转为开放手术的患者和264例随机选择的患者组成。使用逻辑回归分析评估转化风险因素，该模型将某事件的概率建模为独立因素的函数。具有所有解释变量的回归模型中具有统计学意义的因素是年龄，紧急治疗，急性胆囊炎，腹膜粘连，慢性胆囊炎和炎性浸润。在临床情况下，使用预测性风险评估或列线图可能是进行风险分层的最有用工具。使用这种预测工具，临床医生可以根据已知的转换风险因素优化护理，并且可以更好地告知患者手术风险。腹膜粘连，慢性胆囊炎和炎症浸润。在临床情况下，使用预测性风险评估或列线图可能是进行风险分层的最有用工具。使用这种预测工具，临床医生可以根据已知的转换风险因素优化护理，并且可以更好地告知患者手术风险。腹膜粘连，慢性胆囊炎和炎症浸润。在临床情况下，使用预测性风险评估或列线图可能是进行风险分层的最有用工具。使用这种预测工具，临床医生可以根据已知的转换风险因素优化护理，并且可以更好地告知患者手术风险。