Topic:	Digestive Diseases (DD)
Title:	Factors Associated with Conversion to Laparotomy in Patients Undergoing Laparoscopic Appendectomy.
Author:	Liu, S., et al.
Source:	Journal of the American College of Surgeons. 193(3): 298-305. March 2002.
Availability:	Available from Journal of the American College of Surgeons. P.O. Box 2127, Marion, OH 43306-8227. (800) 214-8489 or (740) 382-3322. Fax (740) 382-5866.
Abstract:	Laparoscopic appendectomy (LA) has been increasingly adopted for its advantages over the open technique, but there is a possibility of conversion to open appendectomy (OA) if complications occur or the extent of inflammation of the appendix prohibits successful dissection. This article reports on a study undertaken to identify the preoperative predictors for conversion from laparoscopic to open appendectomy. The authors retrospectively reviewed the medical records of 705 consecutive patients who underwent surgery for suspected appendicitis (inflamed appendix). LA was attempted in 595 patients by 25 different surgeons. Conversion to OA occurred in 58 of these 595 patients (9.7 percent). The most common reason for conversion was dense adhesions due to inflammation, followed by localized perforation and diffuse peritonitis. Based on 261 patients evaluated by CT scan preoperatively, significant factors associated with conversion to OA were age, diffuse tenderness on physical examination, and a surgeon with less experience. The presence of significant fat stranding associated with fluid accumulation, inflammatory mass, or localized abscess in CT scan also significantly increased the possibility of conversion. 5 tables. 38 references.
Format:	Journal Article
Language:	English.
Major Keywords:	Digestive System Diseases. Appendectomy. Laparoscopy. Surgical Techniques. Patient Selection. Preoperative Care.
Minor Keywords:	Risk Factors. Complications. Surgery. Patient Care Management. Appendicitis. Diagnostic Tests. CAT Scan. Inflammation. Abdominal Pain.
Publication Number:	DDJA09206
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