BACKGROUND: Laparoscopic appendectomy is the gold standard surgical procedure currently performed for acute appendicitis. The conversion rate is one of the main factors used to measure laparoscopic competence, being important to avoid wasting time in a laparoscopic procedure and proceed directly to open surgery. AIMS: To identify the main preoperative parameters associated with a higher risk of conversion in order to determine the surgical method indicated for each patient. METHODS: Retrospective study of patients admitted with acute appendicitis who underwent laparoscopic appendectomy. A total of 725 patients were included, of which 121 (16.7%) were converted to laparotomy. RESULTS: The significant factors that predicted conversion, identified by univariate and multivariate analysis, were: the presence of comorbidities (OR 3.1; 95%CI; p<0.029), appendicular perforation (OR 5.1; 95%CI; p<0.003), retrocecal appendix (OR 5.0; 95%CI; p<0.004), gangrenous appendix, presence of appendicular abscess (OR 3.6; 95%CI; p<0.023) and the presence of difficult dissection (OR 9.2; 95%CI; p<0.008). CONCLUSIONS: Laparoscopic appendectomy is a safe procedure to treat acute appendicitis. It is a minimally invasive surgery and has many advantages. Preoperatively, it is possible to identify predictive factors for conversion to laparotomy, and the ability to identify these reasons can aid surgeons in selecting patients who would benefit from a primary open appendectomy.

Gallbladder polyps (GBP) are defined as developed masses inside the wall of the gallbladder; most of them (90%) are nontumor lesions. Abdominal ultrasound is the main and the first line radiological modality for their diagnosis and their risk lamination. We conducted a 12 year retrospective study between 2009 and 2020, which included patients who had preoperative transabdominal ultrasonography showing gallbladder polyps and had undergone cholecystectomy, and for whom postoperative pathology results were available, as well as patients who had at least one polyp discovered on the histopathological exam and who were not determined preoperatively. A total of 70 patients were identified. Preoperative diagnosis of vesicular polyp by ultrasound was carried in 82.9% of patients. The number of ultrasounds performed per person was 1.2 ± 0.47. The polyps’ size in mm was on average 6.14 ± 2.6 with extremes between 3 and 13 mm. On anatomopathological examination, a polyp was objectified in 33.3% of cases. In our series, abdominal ultrasound had a low sensitivity at 36.4%. We aim to provide the accuracy of abdominal ultrasound for the diagnosis of GBP, as a low-cost modality, and to evaluate the concordance of preoperative ultrasound imaging with postoperative pathology.