Özet:

Purpose: Laparoscopic cholecystectomy is clearly superior to open surgery with its advantages, such as the shorter post-operative hospital stay, lower morbidity, better cosmetic results and the ability to return to daily activities faster. However, in some cases, transition to the open technique may be inevitable to manage the patient’s safety or the complication that has occurred. Although many studies have identified various risk factors, variables such as technical facilities, surgical techniques and experience affect risk factors. Our research is aimed at identifying these risk factors. Method: In the study, 2,483 cholesystectomy events performed in our hospital’s general surgical clinic between December 2013 and 2016 were examined retrospectively. Started with open surgery and applied during another surgery, 110 cholesystectomy phenomena were disabled, and 88 patients were selected for the study, starting with laparoscopic and passing to open surgery. Information on the demographic and clinical characteristics of patients is obtained from the hospital records. Compared by obtaining the data of the equal number of patients selected successively from the laparoscopic completed patients, it was assessed whether these factors have a meaningful effect on the transition. Results: The transition rate from laparoscopic cholecystectomy to openness was 3.7%, while the most common cause of the transition to openness was inflammation-related adhesion (n=65, 73.9%). On the transition, men’s gender, advanced age, diabetes, supernatural median cutting, multi-millimeter calculate and wall thickness increases have a significant effect (p<0,001), while the body mass index, pancreatitis, collangitis, endoscopic retrograd collanjiopankreatography or western surgery history, anesthesia assessment score and laboratory values have not been significantly related (p>0,05). The bed and operation periods were significantly longer in the group revealed (p<0,001). The result: male sex, advanced age, the presence of diabetes, the presence of supernatural median cutting, multi-millimeter calculate and the increase in the thickness of the wall in ultrasound is associated with increased disclosure transition rates. If the combination of the parameters we find meaningful in the preoperative period may be difficult to identify and the risk of disclosure may be increased, considering that it is not selected as a training fact, we can take measures such as the involvement of an experienced surgical team in the surgery, the planning of the surgical room, providing the patient with more detailed information.

Anahtar Kelimeler: