title: Reasons and risk factors for intraoperative conversion from laparoscopic to open cholecystectomy.
abstract: OBJECTIVE
  The aim of this study was to analyze the reasons and risk factors for intraoperative conversion from laparoscopic cholecystectomy to open cholecystectomy.
  
  
  METHODS
  The study involved 407 patients in whom laparoscopic cholecystectomy was planned between January 1998 and July 2006. The patients were divided into two groups (the LC completed group and the conversion group), and the two groups were compared.
  
  
  RESULTS
  Laparoscopic surgery was intraoperatively converted to open surgery in 47 cases (11.6 %). The reasons for the conversion consisted of adhesions (15 cases), inflammation (8 cases), adhesion plus inflammation (9 cases), bleeding (8 cases), common bile duct injury (4 cases), suspected common bile duct injury (1 case), injury of the duodenal bulb (1 case) and respiratory disorder (1 case). The group of patients who required conversion to open surgery had a significantly higher percentage of males (P = 0.042) and prevalence of acute cholecystitis (P < 0.001) than the group of patients for whom laparoscopic surgery could be completed. A multivariate logistic regression analysis of these significant predictors showed that male sex [odds ratio (OR) 1.95] and acute cholecystitis (OR 8.45) were significant.
  
  
  CONCLUSIONS
  Particular attention is needed when laparoscopic surgery is considered for male patients with acute cholecystitis.
authors.affiliation: Department of Surgery, Aoto Hospital, The Jikei University School of Medicine, 6-41-2 Aoto, Katsushika, Tokyo, 125-8506, Japan, h-yajima@u01.gate01.com.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Yajima
authors.forename: Hideki
authors.initials: H
authors.lastname: Kanai
authors.forename: Kyonsu
authors.initials: K
authors.lastname: Son
authors.forename: Kazuhiko
authors.initials: K
authors.lastname: Yoshida
authors.forename: Katsuhiko
authors.initials: K
authors.lastname: Yanaga
mesh_terms: D000368:Aged; D016063:Blood Loss, Surgical; D002763:Cholecystectomy / Q000379:methods*; D017081:Cholecystectomy, Laparoscopic; D003135:Common Bile Duct / Q000293:injuries; D005260:Female; D006801:Humans; D007249:Inflammation; D007432:Intraoperative Period; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D012120:Respiration Disorders; D012307:Risk Factors; D000267:Tissue Adhesions