Preoperative risk factors for conversion from laparoscopic to open cholecystectomy: a validated risk score derived from a prospective U.K. database of 8820 patients.

RP Sutcliffe, M Hollyman, J Hodson, G Bonney, RS Vohra, EA Griffiths, CholeS study group, West Midlands Research Collaborative

Research output: Contribution to journalArticlepeer-review

51 Citations (Scopus)

Abstract

Background
Laparoscopic cholecystectomy is commonly performed, and several factors increase the risk of open conversion, prolonging operating time and hospital stay. Preoperative stratification would improve consent, scheduling and identify appropriate training cases. The aim of this study was to develop a validated risk score for conversion for use in clinical practice.
Patients and methods
Preoperative patient and disease-related variables were identified from a prospective cholecystectomy database (CholeS) of 8820 patients, divided into main and validation sets. Preoperative predictors of conversion were identified by multivariable binary logistic regression. A risk score was developed and validated using a forward stepwise approach.
Results
Some 297 procedures (3.4%) were converted. The risk score was derived from six significant predictors: age (p = 0.005), sex (p < 0.001), indication for surgery (p < 0.001), ASA (p < 0.001), thick-walled gallbladder (p = 0.040) and CBD diameter (p = 0.004). Testing the score on the validation set yielded an AUROC = 0.766 (p < 0.001), and a score >6 identified patients at high risk of conversion (7.1% vs. 1.2%).
Conclusion
This validated risk score allows preoperative identification of patients at six-fold increased risk of conversion to open cholecystectomy.
Original languageEnglish
Pages (from-to)922-928
JournalHPB : the official journal of the International Hepato Pancreato Biliary Association
Volume18
Issue number11
DOIs
Publication statusPublished - Aug 2016

Fingerprint

Dive into the research topics of 'Preoperative risk factors for conversion from laparoscopic to open cholecystectomy: a validated risk score derived from a prospective U.K. database of 8820 patients.'. Together they form a unique fingerprint.

Cite this