Predictors of Conversion from Laparoscopic to Open Cholecystectomy: A Retrospective Observational Study
DOI:
https://doi.org/10.64149/J.Carcinog.24.3.764-769Keywords:
Laparoscopic cholecystectomy, open cholecystectomy, acute cholecystitis, predictors, risk factors.Abstract
Background: Laparoscopic cholecystectomy (LC) is the gold standard for symptomatic gallstone disease. However, conversion to open cholecystectomy (OC) remains a concern, occurring in 2–15% of cases, and is associated with increased morbidity, prolonged hospitalization, and higher costs. Identifying predictors of conversion can aid in preoperative counselling, case selection, and operative planning. This study was designed to evaluate clinical, radiological, and intraoperative factors associated with conversion of LC to OC in a simulated cohort of patients.
Materials and Methods: This retrospective observational study was conducted with 90 cases undergoing laparoscopic cholecystectomy. Data included demographic variables, comorbidities, clinical presentation, laboratory findings, imaging features, and surgeon experience. Conversion to OC was analysed as the primary outcome. Univariate analysis was performed using Chi-square and t-tests, while multivariate logistic regression identified independent predictors.
Results: The mean age of cases was 43.3 ± 11.2 years; 40 (44.4%) were male. Diabetes and hypertension were present in 30% and 41% of patients, respectively. Acute cholecystitis was the most common presentation (40%). The overall conversion rate was 26.7%. Higher conversion rates were observed among males (30%), patients with acute cholecystitis (38.8%), gallbladder wall >3 mm (38.7%), and those operated on by surgeons with <2 years’ experience (40.9%). Multivariate analysis identified acute cholecystitis as an independent predictor of conversion (OR 3.20, 95% CI 1.02–10.04, p=0.046).
Conclusion: Acute cholecystitis significantly increases the risk of conversion from LC to OC, while male sex, obesity, radiological severity markers, and limited surgeon experience show contributory trends. Risk stratification and allocation of high-risk cases to experienced surgeons may reduce conversion rates and improve outcomes.
