Risk Factors for Open Conversion in Minimally Invasive Cholecystectomy

Background and Objectives: Open conversion (OC) occurs in 5 to 10% of laparoscopic cholecystectomies (LCs) and results in suboptimal outcomes. Herein, we report our experience with OC in cholecystectomy performed with the minimally invasive (MIS) approach. Methods: Data from 960 minimally invasive cholecystectomies performed in the University of Illinois at Chicago (UIC) Division of General, Minimally Invasive, and Robotic Surgery were retrospectively compiled. Patient demographics and outcomes were analyzed for the major indicators that may predispose to OC. Results: Male gender and intraoperative diagnosis of acute or gangrenous cholecystitis were identified as statistically significant individual predictors for OC. Conversion incidence was significantly lower in every paired demographic combination when compared with the laparoscopic data. Conclusions: Our retrospective study identified some specific factors associated with significantly higher risk of OC in both laparoscopic and robotic cholecystectomy. The impact of these risk factors seems to be lesser in the robotic than in the laparoscopic approach. Further investigation is necessary to validate these findings.