International Surgery Journal | July 2018 | Vol 5 | Issue 7 Page 2455 International Surgery Journal Alluaibi AB et al. Int Surg J. 2018 Jul;5(7):2455-2460 http://www.ijsurgery.com pISSN 2349-3305 | eISSN 2349-2902 Original Research Article Determinants of conversion during laparoscopic cholecystectomy among a sample of Iraqi patients Abutalib B. Alluaibi*, Bahaa K. Hassan, Alaa H. Ali, Ahmed A. Muhsen INTRODUCTION Cholecystectomy is one of the commonest elective surgical procedures performed today with over 500 000 operations being performed annually in the United States alone. It is considered the treatment of choice for a lot of gall bladder diseases, on the top of which is the symptomatic gall stones and biliary colic. 1 In 1987, Philip-Mouret performed the 1 st human laparoscopic cholecystectomy. Since that time, laparoscopic cholecystectomy has become the standard treatment for symptomatic gall stone. 2 It is not only supplanted open cholecystectomy, but also more or less ended the attempts for non-invasive management of gall stones, such as extracorporeal shockwave and bile salt therapy. Evidence is accumulating that the cholecystectomy rate has risen markedly following the ABSTRACT Background: Laparoscopic cholecystectomy has become a standard technique for gall bladder surgery of symptomatic cholelithiasis. However, conversion to open cholecystectomy is sometimes necessary. The aim of the present study was to assess the predictive factors that increase the possibility of conversion of laparoscopic cholecystectomy to open cholecystectomy. Methods: A total of 621 laparoscopic cholecystectomies were attempted at AL-Mawanee General Hospital and AL- Sader Teaching Hospital in Basrah, IRAQ from June 2012 till June 2016.Of these,43 had to be converted to open cholecystectomies. Patients assessed according to different factors, including age, sex, acute cholecystitis, adhesions of gallbladder and calot's triangle, obesity, previous abdominal surgery, anatomical variation of gallbladder and Calot's triangle and intraoperative complications (bleeding, bile duct injury, visceral injury). Results: Conversion to open cholecystectomy was performed in 43 patients (6.92%). The significant factors for conversions were adhesions of gallbladder and Calot's triangle(39.53%) followed by acute cholecystitis(34.88%). Rate of conversion in other factors are as the following i.e., isolated male gender (0%), age (0%), previous abdominal surgery (9.3%), obesity (2.33%), anatomical variations of gall bladder and calot's triangle (2.33%), intra operative complications including bleeding (4.65%), bile duct injury (4.65%), visceral injury (2.33%) were insignificant factors for conversion. Conclusions: Adhesions of gallbladder and calot's triangle is the most common predictive factor and cause for conversion from laparoscopic cholecystectomy to open cholecystectomy. Acute cholecystitis found to be the strongest factor for conversion despite its incidence is lower than adhesions of gall bladder and calots triangle. Male gender and age more than fifty years are not direct predictive factors for conversions. Keywords: Conversion, Determinants, Iraq, Laparoscopic cholecystectomy, Open Department of Surgery, Al-Mawanee General Hospital, Basrah, Iraq Received: 28 May 2018 Accepted: 02 June 2018 *Correspondence: Dr. Abutalib B. Alluaibi, E-mail: dr_abutalib_irq@yahoo.com Copyright: © the author(s), publisher and licensee Medip Academy. This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. DOI: http://dx.doi.org/10.18203/2349-2902.isj20182462