Background and Aims: laparoscopic cholecystectomy (lc) is the gold standard for treating symptomatic cholelithiasis. conversion, however, is sometimes necessary. the aim of this study was to determine predictive factors of conversion in patients undergoing lc for various indications in elective and acute settings in a general teaching hospital. Results: conversion to open cholecystectomy was performed in 121 patients (12%). the most frequent reasons for conversion were infiltration/fibrosis of calot's triangle (30%) and adhesions (27%). in the multivariate analyses male gender (oR 1.67, 95% ci 1.07-2.59), age > 65 years (oR 2.10, 95% ci 1.32-3.34), acute cholecystitis (oR 11.8, 95% ci 6.98-20.1), recent acute cholecystitis (oR 4.71, 95% ci 2.42-9.18) and recent obstructive jaundice (oR 20.6, 95% ci 4.52-94.1) were independent predictive factors for conversion.Conclusions: male gender, age > 65 years, (recent) acute cholecystitis and recent obstructive jaundice are independent predictive risk factors for conversion. by appreciating these risk factors for conversion, preoperative patient counselling can be improved.

The age-standardized incidence of GBC declined drastically over the last three decades. An increasing number of early cholecystectomies for gallstones may play a role. Parallel to the decreasing incidence of stomach cancer, the effective treatment of Helicobacter pylori may also have resulted in a lowered incidence of GBC.

Our findings indicate that obliteration of the fistulous tract with BioGlue adversely affects the outcome of TAFR for high transsphincteric fistulas.

The present prospective study shows that the surgeon should be able to select those gallbladders needing a microscopic gallbladder examination. Potentially, about 80% of this kind of routine histology can be reduced.

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