الفهرس 
Introduction and aim of the work
GalibladderOnly 14 pages are availabe for public view
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Abstract
Objective: ?The aim of this study is to evaluate the possibility to predict the technical difficulties of laparoscopic cholecystectomy. Laparoscopic cholecystectomy is the standard of care for the treatment of symptomatic gallbladder disease. Laparoscopic cholecystectomy decreases postoperative pain, allows earlier oral intake, shortens hospital stay, enhances earlier return to normal activity, and improves cosmosis over open cholecystectomy. So, the casuses of conversion from laparoscopic to open cholecystectomy are worthy to study because patients undergo conversion are deprived of the advantages of this laparoscopic technique. Identifying preoperative variables predicting conversion to open surgery improves patient counseling, planning of convalescence, and postoperative expectations. In addition, the surgeon can appropriately predict operative times while maintaining a lower threshold for conversion when intra operative difficulties are encountered. This study includes 60 patients with cholelithiasis and aim to evaluate conversion factors of laparoscopic to open cholecystectomy based on demographic (age, sex), laboratory (CRP, WBC), individual findings and diagnostic imaging findings. It is possible to reliably predict the type of inflammation and its severity. Therefore, an individualized surgical approach can be used for each patients and type of cholecystitis. In this study conversion was significantly more frequent in patients who were older, had a thickened GB wall, and had acute findings of cholecystitis. All of these factors could make the identification of important anatomic structures difficult and make these variables strong risk factors of conversion. Although these factors were associated with high conversion rates, the reason for conversion was inability to define anatomic structures in over half the converted cases. While conversion is not only justified but encouraged for these reason, the inability to define anatomic structures should be surmountable . So, more than 80% of the conversion were preventable if we assume that the inability to define anatomic structure can be prevented. Patients factors, presentation, preoperative imaging, and surgical experience all contributed to the prediction of conversion. Finally, conversion to O.C. should not be considered a failure but a step toward safety in dealing with challenging cases.