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Abstract
This prospective study of risk factors for conversion of LC to open surgery has been conducted on 249 patients underwent laparoscopic cholecystectomy (LC) in the Department of General Surgery, assiut University Hospital, in the period between March2002 and April 2003. In our series 19 cases of LC were converted to open cholecystectomy (7.6%).No mortality occurred in our series, 3 cases (1.2%) of bile duct injuries occurred two of them resulted in conversion . we conclude that among preoperative risk factor for conversion of LC to open cholecystectomy that were studied, previous pancreatitis, age >60 years, acute cholecystitis, previous upper abdominal operations, GB wall thickness >4mm, and distended GB are highly significant risk factors for conversion (p<0.001 for each) ; Also, liver cirrhosis male gender and shrunken GB are significant risk factors (p<0.05). The all mentioned preoperative risk factors are found to be of relatively high positive predictive values. But on the other hand, previous abdominal operations and obesity (BMI > 30kg /m²) are of no significant association with conversion of LC and also of relatively low PPV. From the intraoperative risk factors, obscure anatomy at Calot’s triangle, bleeding cystic artery, and adhesions are of high significant association with conversion of LC (p< 00.01 for each); Also ,bile duct injury gangrenous GB bleeding from GB bed, and, short cystic duct are signify cant risk factors for conversion, and the all mentioned intraoperative risk factors are of relatively high PPV. But accidental tumor discovery ,injury to abdominal viscera, presence of cholecystoenteric fistula, and incarcerated gallstones are not significant risk factors for conversion although they are of high PPV. Operative time ? 120 minutes is neither significant nor of reliable PPV.