BACKGROUND: This study has the objective to evaluate factors implied with conversion from laparoscopic to open procedures. METHOD: We retrospectively analyzed the patients' records submitted to laparoscopic cholecystectomy, from January 2000 to December 2004. RESULTS: One thousand seven hundred and thirty four laparoscopic cholecystectomies were performed during this period. The total conversion rate was 5.7%, scheduled surgery was 5.44% and emergency surgery was 14% (p=0.019). Male patients had a conversion rate of 7.46% and female patients had a conversion rate of 5.39%. (p=0.178). Patients older than 60 need conversion in 11.11%, and among patients younger than 60, the rate was 4.41%. (p=0.01). The main cause of conversion was inflammation/adherence in the structures of the gallbladder pedicle, and was responsible for 42.53%, choledocholithiasis accounted for 17.24%, and suspicion or bile duct injury corresponded to 9.19%. An operative time longer than 120 minutes was observed in 71.43% of converted patients, and 8.2% of non-converted ones. In the converted group, 79.31% were discharged more than 48 hours after surgery, and in the non-converted group, 10.8% were discharged after this period. (p=0,001). CONCLUSION: The risk factor observed in this study was age older than 60 years, emergency surgery and acute cholecystitis. The identification of these factors can help estimate the difficulty of the procedure and permit the surgeon to give better information to the patients about the risk of conversion.
Cholecystectomy; Laparoscopic; Risk factors
