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Cholecystitis

Cholecystitis

Cholecystitis is inflammation of the gallbladder, most commonly caused by obstruction of the cystic duct. This blockage prevents bile from draining, leading to gallbladder distension, inflammation, and potentially serious complications. This condition may present acutely or chronically and can happen with or without gallstones.EtiologyAbout 95% of cholecystitis cases are calculous, caused by gallstones blocking the cystic duct, leading to bile accumulation and inflammation of the gallbladder...

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Risk Factors for Conversion in Laparoscopic Cholecystectomy and Development of a Predictive Nomogram.

Mehmet Berksun Tutan¹, Ramazan Topcu², Veysel Barış Turhan²

¹Department of General Surgery, Alaca State Hospital, Çorum, Türkiye.

Surgical Innovation

|December 24, 2025

Summary

This summary is machine-generated.

Predictors for converting laparoscopic cholecystectomy to open cholecystectomy were identified. Gallbladder wall thickness and dense adhesions are key indicators, aiding surgical planning and patient counseling for improved outcomes.

Keywords:

gallbladder wall thickness laparoscopic cholecystectomy open conversion predictive nomogram risk factors

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Area of Science:

Gastroenterology and Hepatobiliary Surgery
Surgical Oncology
Medical Informatics

Background:

Laparoscopic cholecystectomy (LC) is standard for gallbladder disease, but conversion to open cholecystectomy (OC) occurs in 2-15% of cases.
Conversion increases operative time, morbidity, and hospital stay, necessitating reliable predictors for surgical planning and patient counseling.

Purpose of the Study:

To identify independent predictors of conversion from LC to OC.
To develop a nomogram for estimating individualized conversion risk.

Main Methods:

Retrospective cohort study of 4535 patients undergoing LC.
Analysis of demographic, clinical, laboratory, radiological, intraoperative, and histopathological data.
Univariate and multivariate logistic regression and nomogram development.

Main Results:

Conversion to OC occurred in 6.7% of patients.
Independent predictors included male sex, ASA IV classification, elevated CRP, reduced lymphocyte count, gastric/intestinal complications, gangrenous gallbladder, and xanthogranulomatous cholecystitis.
Gallbladder wall thickness (preoperative) and dense adhesions (intraoperative) were strongest predictors.

Conclusions:

Conversion reflects anatomical complexity and advanced disease, not surgical failure.
Gallbladder wall thickness, inflammatory markers, adhesions, gangrene, and xanthogranulomatous cholecystitis are consistent predictors.
The proposed nomogram aids preoperative planning and patient counseling; prospective validation is needed.