Predictive Factors for Conversion from Laparoscopic to Open Cholecystectomy at a Regional General Hospital in Orizaba, Veracruz, Mexico: A Retrospective Study

Abstract

Background: Conversion from laparoscopic to open cholecystectomy remains an important intraoperative decision when anatomical definition or procedural safety is compromised. Identification of preoperative factors associated with conversion may improve surgical planning and patient counseling. Objective: To identify predictors of conversion from laparoscopic to open cholecystectomy in patients treated at Hospital General Regional No. 1 in Orizaba, Veracruz, Mexico. Materials and Methods: An observational, retrospective, analytical, cross-sectional, single-center study was conducted. A total of 196 medical records of adults who underwent laparoscopic cholecystectomy for cholelithiasis from February 2024 to February 2025 were reviewed. After applying the selection and elimination criteria, 148 patients were included in the final analysis. Descriptive statistics and binary logistic regression were performed. Results: Of the 148 patients analyzed, 98 (66.2%) were women and 50 (33.8%) were men. Conversion to open surgery occurred in 90 patients (60.8%). Age was the only statistically significant predictor in the logistic regression model (p<0.001; OR 1.054; 95% CI 1.028-1.081), representing a 5.4% increase in the odds of conversion for each additional year of age. Sex showed a trend toward statistical significance (p=0.053; OR 2.403; 95% CI 0.990-5.833). Body mass index, leukocytosis, previous abdominal surgery, and type of previous abdominal surgery were not statistically significant. Conclusions: Age was the only independent predictor of conversion identified in this cohort. Previous abdominal surgery was not independently associated with conversion. Larger multicenter studies incorporating additional clinical, imaging, and intraoperative variables are warranted.

Keywords: laparoscopic cholecystectomy; conversion to open surgery; cholelithiasis; risk factors; logistic regression