ID | 55440 |
JaLCDOI | |
フルテキストURL | |
著者 |
Utsumi, Masashi
Department of Surgery, National Hospital Organization, Iwakuni Clinical Center
Aoki, Hideki
Department of Surgery, National Hospital Organization, Iwakuni Clinical Center
Kunitomo, Tomoyoshi
Department of Surgery, National Hospital Organization, Iwakuni Clinical Center
Mushiake, Yutaka
Department of Surgery, National Hospital Organization, Iwakuni Clinical Center
Yasuhara, Isao
Department of Surgery, National Hospital Organization, Iwakuni Clinical Center
Taniguchi, Fumitaka
Department of Surgery, National Hospital Organization, Iwakuni Clinical Center
Arata, Takashi
Department of Surgery, National Hospital Organization, Iwakuni Clinical Center
Katsuda, Koh
Department of Surgery, National Hospital Organization, Iwakuni Clinical Center
Tanakaya, Kohji
Department of Surgery, National Hospital Organization, Iwakuni Clinical Center
Takeuchi, Hitoshi
Department of Surgery, National Hospital Organization, Iwakuni Clinical Center
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抄録 | To identify predictive factors for conversion from laparoscopic cholecystectomy (LC) to open cholecystectomy performed for mixed indications as an acute or elective procedure. We retrospectively analyzed the data of 236 consecutive cases of LC performed in our department between January 2012 and January 2015, and evaluated preoperative risk factors for conversion and the usefulness of the 2013 Tokyo guidelines (TG2013) for diagnosing acute cholecystitis. The conversion rate in our series was 8% (19/236 cases). The following independent predictive factors of conversion were identified (p≤0.04): previous upper abdominal surgery (odds ratio (OR), 14.6), pericholecystic fluid (OR, 10.04), acute cholecystitis (OR, 7.81), and emergent LC (OR, 15.8). Specifically for patients with acute cholecystitis defined using the 2013 Tokyo guidelines, use of an antiplatelet or anticoagulant drug for cardiovascular disease (p=0.043), previous upper abdominal surgery (p<0.031) and a resident as operator (p=0.041) were predictive factors. The risk factors for conversion identified herein could help to predict the difficulty of the procedure and could be used by surgeons to better inform patients regarding the risks for conversion. The TG2013 can be an effective tool for diagnosing acute cholecystitis to make informed clinical decisions regarding the optimal procedure for a patient.
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キーワード | laparoscopic cholecystectomy
conversion
risk factors
acute cholecystitis
Tokyo guidelines 2013
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Amo Type | Original Article
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出版物タイトル |
Acta Medica Okayama
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発行日 | 2017-10
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巻 | 71巻
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号 | 5号
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出版者 | Okayama University Medical School
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開始ページ | 419
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終了ページ | 425
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ISSN | 0386-300X
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NCID | AA00508441
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資料タイプ |
学術雑誌論文
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言語 |
英語
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著作権者 | CopyrightⒸ 2017 by Okayama University Medical School
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論文のバージョン | publisher
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査読 |
有り
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PubMed ID |