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Table 1 Univariate analysis of risk factors for conversion

From: Laparoscopic cholecystectomy for acute calculous cholecystitis: a retrospective study assessing risk factors for conversion and complications

  Conversion (n = 84 22.5 %)a LC (n = 289) Total (n = 373) OR (95% CI) P
Gender; Male 48 (25.4%) 141 (48.8%) 189 (50.7%) 1.4 (0.9–2.3) 0.178
Age in years, median (range) 70 (30–92) 61 (20–94) 63(20–94) NA <0.001
Heart failure 7 (29.2%) 17 (5.9%) 24 (6.4%) 1.5 (0.6–3.6) 0.420
Impaired renal function 2 (18.2%) 9 (3.1%) 11 (2.9%) 0.8 (0.2–3.6) 1.000
Diabetes 23 (33.8%) 45 (15.6%) 68 (18.2%) 2.0 (1.2–3.6) 0.014
Previous laparotomy on the upper abdomen 8 (40.0%) 12 (4.2%) 20 (5.4%) 2.4 (1.0–6.2) 0.054
Previous laparotomy on the lower abdomenb 21 (23.9%) 67 (24.3%) 88 (24.6%) 1.1 (0.6–1.9) 0.805
Previous laparoscopic surgery on the abdomenb 7 (29.2%) 17 (6.2%) 24 (6.7%) 1.4 (0.6–3.6) 0.450
No previous surgeries 52 (21.3%) 192 (66.4%) 244 (65.4%) 0.8 (0.5–1.4) 0.442
Duration of symptoms before admissionc
  < 24 h 18 (14.4%) 106 (40.2%) 124 (36.9%) 0.5 (0.3–0.9) 0.018
 24 h – 48 h 13 (27.1%) 35 (13.3%) 48 (14.3%) 1.4 (0.7–2.9) 0.302
 48 h – 72 h 16 (25.0%) 48 (18.2%) 64 (19.0%) 1.3 (0.7–2.4) 0.439
  > 72 h 25 (25.3%) 75 (28.4%) 100 (29.8%) 1.3 (0.8–2.3) 0.299
 Hours from admission to surgery, median (range, interquartile range) 26 (3–109, 18–42) 29 (3–144, 20–48) 29 (3–144, 20–47) NA 0.156
Total duration from symptoms onset to surgeryc
  < 24 h 12 (21.4%) 44 (16.7%) 56 (16.7%) 1.0 (0.5–2.0) 1.000
 24 h - 48 h 8 (16.3%) 41 (15.5%) 49 (14.6%) 0.7 (0.3–1.5) 0.346
 48 h - 72 h 16 (21.3%) 59 (22.3%) 75 (22.3%) 1.0 (0.5–1.9) 0.982
  > 72 h 35 (22.6%) 120 (45.5%) 155 (46.3%) 1.2 (0.7–2.0) 0.564
Clinical findings
 Pain in right upper quadrant 82 (23.1%) 273 (94.5%) 355 (95.2%) 2.4 (0.5–10.7) 0.235
 Guarding 41 (25.6%) 119 (41.2%) 160 (42.9%) 1.4 (0.8–2.2) 0.213
 Signs of generalized peritonitis 1 (50.0%) 1 (0.3%) 2 (0.5%) 3.5 (0.2–56.0) 0.400
 Palpable gallbladder 6 (30.0%) 14 (4.8%) 20 (5.4%) 1.5 (0.6–4.1) 0.410
Preoperative laboratory data, median of highest results (range, interquartile range)d
 CRP (mg/l) 215 (3–471, 128–299) 123 (3–524, 58–214) 145 (3–524, 66–244) NA <0.001
 WBCC (109/l) 14 (7–38, 12–18) 13 (2.5–32, 10–16) 13 (2.5–38, 10–17) NA 0.018
 ALAT (U/l) 27 (5–222, 17–48) 30 (4–705, 18–63) 29 (4–705, 18–57) NA 0.214
 AFOS (U/l) 85 (48–371, 66–126) 80 (24–621, 61–112) 81 (24–621, 62–113) NA 0.075
 Bilirubin (μmol/l) 15 (4–121, 9–27) 15 (2–230, 9–24) 15 (2–230, 9–24) NA 0.668
Radiographic findingse
 Abscess 1 (100.0%) 0 1 (0.3%) NA 0.226
 Free fluid 9 (36.0%) 16 (5.6%) 25 (6.7%) 2.0 (0.9–4.8) 0.097
 Thickened gallbladder wall 72 (23.2%) 239 (83.0%) 311 (83.6%) 1.2 (0.6–2.4) 0.552
 Preoperative ERCP 3 (17.6%) 14 (4.8%) 17 (4.6%) 0.7 (0.2–2.6) 0.773
Surgical findings
 Abscess 10 (66.7%) 5 (1.7%) 15 (4.0%) 7.7 (2.5–23.1) <0.001
 Perforated gallbladder 12 (33.3%) 24 (8.3%) 36 (9.7%) 1.8 (0.9–3.9) 0.102
Gallbladder perforation during surgery 43 (23.0%) 144 (49.8%) 187 (50.1%) 1.1 (0.7–1.7) 0.826
 Gangrene of the gallbladder identified by surgeon 58 (43.0%) 77 (26.6%) 135 (36.2%) 6.4 (3.6–10.4) <0.001
 Removal of stones from common bile duct 0 0 0 NA NA
 Lead surgeon specialist 32 (25.2%) 94 (32.5%) 126 (33.8%) 1.3 (0.8–2.1) 0.342
 Assistant present 53 (29.9%)f 124 (42.9%) 177 (48.1%) 2.7 (1.6–4.6) <0.001
  1. NA Not applicable, LC Laparoscopic cholecystectomy, OR Odds ratio, CRP C-reactive protein, WBCC White blood cell count, ERCP Endoscopic retrograde cholangiopancretography, ALAT Alanine transferase, AFOS Alkaline phosphatase
  2. apercentages show the proportion of patients with specified risk factor
  3. bFifteen patients had mentions of an appendectomy in their patient journals, but it was not specified whether the procedure was laparoscopic or open
  4. cDuration of symptoms missing from 25 patients in LC and 12 in conversion
  5. dCRP missing from one patient, ALAT missing from seven patients, AFOS missing from eight patients, bilirubin missing from 18 patients
  6. eA total of 239 patients had an ultrasound, 65 had computed tomography (CT) and 62 had both. Magnetic resonance cholangiopancreatography (MRCP) was used in 93 patients. One patient did not undergo any imaging
  7. fAssistant present prior to conversion, info on timing of assistant arrival missing in five cases