title: Risk factors for conversion to open surgery in patients with acute cholecystitis undergoing interval laparoscopic cholecystectomy.
abstract: BACKGROUND
  Laparoscopic cholecystectomy for acute cholecystitis is associated with higher rate of conversion to laparotomy. The value of several factors that might influence the rate of conversion is analysed.
  
  
  METHODS
  In a retrospective analysis of a prospective database, the medical records of patients who underwent laparoscopic cholecystectomy from May 1998 to June 2004 were reviewed. Patients who had acute cholecystitis and had undergone interval laparoscopic cholecystectomy were included in this study.
  
  
  RESULTS
  Out of 1000 laparoscopic cholecystectomies, 201 were operated on for acute cholecystitis. One hundred and forty-five patients (72.3%) underwent successful laparoscopic cholecystectomy and 56 patients (27.7%) needed conversion to open cholecystectomy. Patient's age (P = 0.031), total white cell count (P = 0.014), total bilirubin (P = 0.002), alkaline phosphatase (P = 0.003) and presence of common bile duct stone (P = 0.001) were found to be independently associated with conversion.
  
  
  CONCLUSIONS
  Laparoscopic cholecystectomy can be performed safely for acute cholecystitis. Predictors of conversion will be helpful when planning the laparoscopic approach and for counselling patients preoperatively.
authors.affiliation: Department of General Surgery, Changi General Hospital, Singapore. salleh_ibrahim@cgh.com.sg
authors.forename: Kok Ren
authors.initials: KR
authors.lastname: Lim
authors.forename: Salleh
authors.initials: S
authors.lastname: Ibrahim
authors.forename: Ngian Chye
authors.initials: NC
authors.lastname: Tan
authors.forename: Swee Ho
authors.initials: SH
authors.lastname: Lim
authors.forename: Khoon Hean
authors.initials: KH
authors.lastname: Tay
mesh_terms: D000328:Adult; D017081:Cholecystectomy, Laparoscopic / Q000009:adverse effects* / Q000706:statistics & numerical data; D041881:Cholecystitis, Acute / Q000453:epidemiology / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D012189:Retrospective Studies; D012307:Risk Factors; D012846:Singapore