• ABSTRACT
    • Background/Aims: Laparoscopic cholecystectomy (LC) has become the gold standard for treating sy¬m¬ptomatic cholelithiasis. However, there are still some risk factors will lead to conversion to o¬p¬en cholecystectomy. The main aim of this meta-analysis is to evaluate preoperative risk fact¬o¬rs for converting laparoscopic to open cholecystectomy (LOC).
  • METHODOLOGY
    • Evaluated risk factors of all clinical studies published from 1990 to 2012. All kinds of converting laparoscopic to open cholecystectomies were searched in the the Med-line, Embase, Science Citation Index, and PubMed databases. Random and fixed-effect models were used to aggregate the study endpoints and assess heterogeneity. The RevMan 5.2 was used for pooled estimates.
  • RESULTS
    • Eleven NRCTs containing 14645 patients (940 in the LOC group and 13705 in the LC group) were included in the present meta-analysis. From the pooled analyses, age > 65 years (OR = 1.83, 95% CI (1.31, 2.45), P < 0.0001), male gender (OR = 2.23, 95% CI (1.59, 3.12), P < 0.00001), Diabetes Mellitus (OR = 1.89, 95% CI (1.30, 2.75), P = 0.0009), acute cholecystitis (OR = 3.37, 95% CI (1.83, 6.20), P < 0.0001), thickened gallbladder wall (OR = 6.04, 95% CI (4.11, 8.88), P < 0.00001) and previous upper abdominal surgery (OR = 4.43, 95% CI (2.17, 9.04), P < 0.00001) were independent predictive risk factors for conversion. Previous lower abdominal surgery, preoperative endoscopic retrograde cholangiopancreatography (ERCP) and the gallstone pancreatitis were not significantly associated with conversion (all P > 0.05).
  • CONCLUSION
    • Our meta-analysis indicates that age > 65 years, male gender, acute cholecystitis, t¬hickened gallbladder wall, Diabetes Mellitus and previous upper abdominal surgery were sign¬i¬ficantly associated with increased risk of conversion. Evaluating these factors was useful for t¬h¬e doctors to make suitable operation scheme.