Yahya Alperen BAYRAKTAR, Mehmet Eşref ULUTAŞ, İsmail HASIRCI
Annals of Clinical and Analytical Medicine - 2026;17(4):373-377
Aim: Laparoscopic cholecystectomy (LC) is considered the gold standard in the surgical treatment of gallbladder diseases. However, conversion to open surgery may be necessary in certain situations. This study aims to retrospectively evaluate cases converted to open surgery among LC procedures performed at our center over 13 years. Methods: Adult patients who were scheduled for LC but required conversion to open cholecystectomy during surgery between January 1, 2008, and January 1, 2021, were included. Demographic data, clinical features, laboratory findings, reasons for conversion, and postoperative outcomes were analyzed. Results: Out of 9580 LC cases, 49 patients (0.5%) required conversion to open surgery. The most common reason for conversion was dense adhesions in Calot's triangle (77.6%), followed by organ injury (14.3%). A history of previous abdominal surgery was significantly more common in patients with adhesions (p < 0.001), while a history of cholecystostomy was more frequent in those converted due to severe inflammation (p = 0.016). Patients with organ injuries had significantly lower hemoglobin levels (p = 0.006) and a higher rate of reoperation (p = 0.01). Conclusion: In our study, the rate of conversion from LC to open surgery was notably lower than rates reported in the literature. Advanced age, male gender, dense adhesions, and prior abdominal surgery were identified as major risk factors for conversion. Proper patient selection, surgical experience, and appropriate technical approaches can reduce conversion rates. In cases of anatomical difficulty or high complication risk, early conversion or alternative surgical strategies, such as partial cholecystectomy, should be considered.
