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Lookup NU author(s): Dr Sarah Robinson, Paul Gallagher, Venkatesh Kanakala
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© 2016 International Hepato-Pancreato-Biliary Association Inc. 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.
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Publication type: Article
Publication status: Published
Journal: HPB
Year: 2016
Volume: 18
Issue: 11
Pages: 922-928
Print publication date: 01/11/2016
Online publication date: 30/08/2016
Acceptance date: 28/07/2016
ISSN (print): 1365-182X
ISSN (electronic): 1477-2574
Publisher: Elsevier B.V.
URL: http://doi.org/10.1016/j.hpb.2016.07.015
DOI: 10.1016/j.hpb.2016.07.015
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