This is the Scientific Surgery Archive, which contains all randomized clinical trials in surgery that have been identified by searching the top 50 English language medical journal issues since January 1998. Compiled by Jonothan J. Earnshaw, former Editor-in-Chief, BJS
Timing of urgent laparoscopic cholecystectomy does not influence conversion rate. BJS 2004; 91: 601-604.
Published: 22nd March 2004
Authors: J. S. Knight, S. J. Mercer, S. S. Somers, A. M. Walters, S. A. Sadek, S. K. C. Toh et al.
Background
The optimal treatment of acute gallstone disease is urgent laparoscopic cholecystectomy, but there is confusion about the effect of delay in operation on conversion rates. Most reports suggest that delay beyond 3 or 4 days leads to a higher conversion rate. This study assessed the conversion rate in relation to the timing of laparoscopic surgery.
Method
This institution operates a specialist‐led protocol for the urgent management of all admissions with acute gallstone disease. Data were collected prospectively over 6 months.
Results
Between March and August 2002, 84 patients with acute gallstone disease underwent urgent laparoscopic cholecystectomy at the index admission with an overall conversion rate of 12 per cent. Four of 40 procedures carried out within 3 days of admission were converted, compared with six of 44 after 3 days. Five of 46 carried out within 4 days of admission were converted, compared with five of 38 after 4 days. There were no deaths and one common bile duct injury.
Conclusion
As long as the procedure is carried out by experienced upper gastrointestinal surgeons working within a specialist‐led protocol, the conversion rate for laparoscopic cholecystectomy can be as low as 12 per cent. The timing of urgent laparoscopic cholecystectomy has no impact on the conversion rate. Copyright © 2004 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.
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