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Related Experiment Video

Updated: Jun 25, 2026

Laparoscopic Choledochal Cyst Excision and Roux-en-Y Choledochojejunostomy in Adults
04:14

Laparoscopic Choledochal Cyst Excision and Roux-en-Y Choledochojejunostomy in Adults

Published on: February 28, 2025

Conversion after laparoscopic cholecystectomy in England.

M Ballal1, G David, S Willmott

  • 1Department of Surgery, Mid Cheshire Hospitals NHS Foundation Trust, Leighton Hospital, Middlewich Road, Crewe, CW1 4QJ, UK.

Surgical Endoscopy
|March 7, 2009
PubMed
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Factors influencing conversion from laparoscopic to open surgery for gallstones were identified. Higher surgeon caseloads and hospital rates correlated with fewer conversions, emphasizing surgeon experience and hospital organization for better outcomes.

Area of Science:

  • Surgical Outcomes
  • Health Services Research

Background:

  • Laparoscopic cholecystectomy is the standard treatment for symptomatic gallstones.
  • Conversion to open surgery occurs in 5-10% of cases, necessitating identification of predictive factors.

Purpose of the Study:

  • To identify patient-related and non-patient-related factors associated with conversion from laparoscopic to open cholecystectomy in English hospitals.
  • To analyze data from a national administrative database to understand conversion predictors.

Main Methods:

  • Analysis of 43,821 laparoscopic cholecystectomies from the Hospital Episode Statistics database (2005-2006).
  • Calculation of individual surgeon caseload and hospital conversion rates from baseline year data.
  • Statistical analysis of factors influencing conversion in the index year.

Related Experiment Videos

Last Updated: Jun 25, 2026

Laparoscopic Choledochal Cyst Excision and Roux-en-Y Choledochojejunostomy in Adults
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Laparoscopic Choledochal Cyst Excision and Roux-en-Y Choledochojejunostomy in Adults

Published on: February 28, 2025

Main Results:

  • Overall conversion rate was 5.2% (4.6% elective, 9.4% emergency).
  • Predictive factors for conversion included male sex, emergency admission, older age, and complicated gallstones (p < 0.001).
  • Higher individual surgeon caseload and prior hospital conversion rates were significant predictors (p < 0.001).

Conclusions:

  • Increased consultant surgeon caseload is associated with lower conversion rates.
  • Urgent need for operations to be performed by surgeons with adequate experience.
  • Significant inter-hospital variation in conversion rates highlights implications for training and service organization.