关键词: 中转开腹, 腹腔镜胆囊切除术, 预测, 评分系统

Abstract: ［Abstract］ Objective To investigate the role of the systemic inflammatory response and local anatomy in reducing the conversion rate during the approach of laparoscopic cholecystectomy. Methods A total of 892 patients admitted to our hospital between February 2005 and February 2015 were analyzed retrospectively. All their cholecystitis onset were smaller than 72 hours and all of them underwent surgery. The patients were divided into two group according to the time when the approach of laparoscopic cholecystectomy， and the role of the systemic inflammatory response and local anatomical factors affecting the conversion of laparoscopic cholecystectomy were discussed. Results All 892 patients underwent surgery without any intraoperative or postoperative deaths. There were no significant differences in age， gender and body mass index between groups A and B（P>0.05）. The difference of probability of conversion was significantly in the aspect of factors including fever（≥38.5℃）， peritonitis， white blood cell（WBC≥18.0×109/L）， C-reactive protein （CRP≥30.0 mg/L） and gallbladder wall thickness（≥0.8 cm） （P<0.05）. Conclusion The assessment of fever， peritonitis， WBC， CRP and the local anatomical of gallbladder can effectively reduce the rate of conversion.

Key words: conversion, laparoscopic cholecystectomy, scoring system, prediction