Table 1 Univariate analysis of risk factors for conversion
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 |