Predictability of conversion from laparoscopic to open cholecystectomy: retrospective analysis of risk factors

Laparoscopic Cholecystectomy [LC] is the gold standard operation for cholelithiasis; however, conversion to [Open Cholecystectomy [OC]] is still required in some patients. Is to assess the predictability of conversion by recognition of probable risk factors, a fact that would be beneficial for patient selection and planning of laparoscopic procedures. Retrospective analysis of data concerning 1350 cases of LC in the last 8 years from 2001 to 2008. A total of 28 patients required conversion [overall conversion rate of 2.1%]. Preoperative clinical, laboratory and radiological data were evaluated with regard to conversion. Six factors; male gender, age above 45 years, presentation as acute cholecystitis[ACs], history of repeated attacks of ACs, ultrsonographic gall bladder wall thickness of more than 3 mm. and previous history of upper abdominal operation; showed a statistically significant effect on conversion. Three other factors; raised white Blood Cell [WBC] count, Common Bile Duct [CBD] stone[s] and experience of the surgeon; failed to reach significance. On the basis of Univariate analysis results, all significant predictors were allocated a score, which indicate risk score for conversion. Increasing score was associated with a significantly increased probability of conversion. The optimal cutoff score was 2 with a conversion rate of 3.05%. Conversion rate was 20% with a score of 8. Risk of conversion is predictable on basis of this scoring. Patients predicted to have high risk of conversion may be informed and scheduled appropriately