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Research Paper | General Surgery | Volume 15 Issue 7, July 2026 | Pages: 918 - 921 | India
Preoperative and Intraoperative Predictors of Conversion from Laparoscopic to Open Cholecystectomy: A Retrospective Cohort Study
Abstract: Background: Laparoscopic cholecystectomy (LC) remains the accepted first-line treatment for symptomatic gallstone disease, yet a clinically important minority of cases cannot be completed laparoscopically. This study aimed to define preoperative and intraoperative predictors of conversion to open cholecystectomy in a rural North Indian tertiary care setting. Methods: This retrospective cohort study examined 118 consecutive patients who underwent LC at Muzaffarnagar Medical College and Hospital between January 2025 and May 2026. Preoperative, intraoperative, and postoperative variables were compared between converted and non-converted cases. Variables reaching p < 0.10 on univariate analysis were entered into a multivariate backward stepwise logistic regression model. Results: Thirteen of 118 patients (11.0%; 95% CI 6.0-18.0%) required conversion to open cholecystectomy. Five preoperative variables independently predicted conversion: acute cholecystitis (OR 4.67), gallbladder wall thickness ≥4 mm on ultrasound (OR 3.84), male sex (OR 3.21), previous upper abdominal surgery (OR 2.93), and elevated serum alkaline phosphatase (OR 2.41). Dense pericholecystic adhesions accounted for 53.8% of intraoperative conversions. Converted patients had significantly longer operative time, greater blood loss, and prolonged hospital stay (all p < 0.001). Conclusion: A simple five-factor preoperative risk score, comprising male sex, acute cholecystitis, gallbladder wall thickness ≥4 mm, prior upper abdominal surgery, and elevated serum ALP, can meaningfully stratify conversion risk and support theatre planning and patient counselling. Prospective, multicentre validation is required before routine clinical adoption.
Keywords: laparoscopic cholecystectomy, conversion, open cholecystectomy, predictors, Calot's triangle, Critical View of Safety, gallstone disease, acute cholecystitis, risk stratification
How to Cite?: Mohd Sameer Gour, Izhar Qadir, Bharat Jalan, "Preoperative and Intraoperative Predictors of Conversion from Laparoscopic to Open Cholecystectomy: A Retrospective Cohort Study", Volume 15 Issue 7, July 2026, International Journal of Science and Research (IJSR), Pages: 918-921, https://www.ijsr.net/getabstract.php?paperid=MR26711210653, DOI: https://dx.doi.org/10.21275/MR26711210653