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Conversion cholecystectomy in patients with acute cholecystitis—it’s not as black as it’s painted!

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Abstract

Background

Although laparoscopic cholecystectomy is recommended as standard treatment for acute cholecystitis, in 10–30 % a conversion to open cholecystectomy is required. Among some surgeons, this is still perceived as a “complication.” The aim of our study was to define characteristics and outcome of patients with acute cholecystitis undergoing conversion cholecystectomy.

Methods

Over a 9-year period, 464 consecutive patients undergoing cholecystectomy for acute cholecystitis were analyzed for demographic, preoperative, intraoperative, histopathological, and laboratory findings and surgical outcome parameters.

Results

Patients with conversion cholecystectomy were characterized by younger age, lower American Society of Anesthesiologists (ASA) score, and less cardiac comorbidities compared to patients with primary open cholecystectomy. Severity of inflammation on the clinical and histopathological level was similar and comparable. Overall complication rate, mortality, and median hospital stay were significantly lower compared to those of primary open cholecystectomy group.

Conclusions

There are no disadvantages for patients undergoing conversion cholecystectomy compared to primary open cholecystectomy. The outcome is influenced by general condition and comorbidities rather than by the surgical approach. Underlying fear of conversion should not avoid a laparoscopic approach in patients with acute cholecystitis.

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Acknowledgments

This study was presented at the annual meeting of the German Surgical Society in 2013 (130. Kongress der Deutschen Gesellschaft für Chirurgie, ID: 978).

Authors’ contributions

Study conception and design: Johannes Spohnholz, Ansgar Chromik, and Waldemar Uhl

Acquisition of data: Johannes Spohnholz (all data except histopathological findings) and Johanna Munding (histopathological findings)

Analysis and interpretation of data: Johannes Spohnholz and Ansgar Chromik

Drafting of manuscript: Johannes Spohnholz, Ansgar Chromik, and Torsten Herzog

Critical revision of manuscript: Johannes Spohnholz, Ansgar Chromik, Johanna Munding, Torsten Herzog, Chris Braumann, Orlin Belyaev, and Waldemar Uhl

Author information

Authors and Affiliations

  1. Department of General and Visceral Surgery, St. Josef-Hospital, Ruhr-University Bochum, Gudrunstrasse 56, 44791, Bochum, Germany

    Johannes Spohnholz, Torsten Herzog, Orlin Belyaev, Waldemar Uhl, Chris Braumann & Ansgar Michael Chromik

  2. Institute of Pathology, Ruhr-University Bochum, Bochum, Germany

    Johanna Munding

Authors
  1. Johannes Spohnholz
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  2. Torsten Herzog
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  3. Johanna Munding
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  4. Orlin Belyaev
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  5. Waldemar Uhl
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  6. Chris Braumann
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  7. Ansgar Michael Chromik
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Corresponding author

Correspondence to Ansgar Michael Chromik.

Ethics declarations

The protocol of this retrospective cohort study was approved by the ethics committee of the Ruhr-University Bochum, Germany (Permission no. 5059–14).

Because this was a retrospective analysis and the names of the patients were anonymized, informed consent from all individual participants was not needed.

Conflict of interest

All authors declare that they have no conflict of interest.

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Spohnholz, J., Herzog, T., Munding, J. et al. Conversion cholecystectomy in patients with acute cholecystitis—it’s not as black as it’s painted!. Langenbecks Arch Surg 401, 479–488 (2016). https://doi.org/10.1007/s00423-016-1394-3

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  • DOI: https://doi.org/10.1007/s00423-016-1394-3

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