Correspondence to Author: Raad Fadhel Al Rubaey. 

Department of Surgery, Hammurabi College of Medicine, University of Babylon, Babylon, Iraq

DOI: 10.52338/jjogastro.2025.5133

Abstract:

Background: However, a major quality measure in biliary surgery, conversion from laparoscopic to open cholecystectomy (LC to OC), has widely different rates and risk elements across areas. Although symptomatic cholelithiasis now calls for LC, intraoperative difficulties sometimes call for conversion, which affects patient outcomes and healthcare expenses. Comparative regional data are restricted, particularly for Iraq
Objectives: Find major risk factors to estimate the LC to OC conversion rate in Iraq, and then correlate these results with those from nearby nations to provide context for results and call attention to surgical opportunities
Materials & Methods: This retrospective cohort study was conducted from September 2020 to April 2024 on 880 patients undergoing LC for symptomatic cholelithiasis at three main hospitals in Hilla, Iraq. Hospital records were mined for patient demographics, surgical specifics, and the causes of conversion. Using descriptive statistics and multivariate logistic regression, conversion rates and risk variablesincluding age, sex, and gallbladder wall thicknesswere examined. By employing harmonic definitions and statistical techniques, comparative data from recent regional investigations (2010–2023) were rigorously examined.
Results:With 4.1% (36/880), the conversion rate in Iraq was lower than that in Saudi Arabia (7.3%) and Iran (8.0%) but higher than that in Japan (2.3%). Male sex (aOR 7.46, 95% CI: 2.89–9.38) and gallbladder wall thickness >3 mm (aOR, 3.8) were the most powerful independent predictors of conversion. Patients aged ≥50 years also had a higher risk (aOR 3.06). Unclear anatomy (44.4%) and intraoperative hemorrhage (22.2%) were the most common causes of conversion. Regional comparisons showed similar risk patterns, although the rates of uncertain anatomy were notably greater in Saudi Arabia (79.7%). Factors including surgeon experience, facility resources, and study design (single-center, retrospective) might impact the observed rates and restrict direct cross-country comparisons
Conclusion: With male sex, older age, and thicker gallbladder walls as consistent risk variables, Iraq’s conversion rate is comparable to or better than that of several regional neighbors. Further lowering of conversion rates could be accomplished by improving preoperative imaging, continuous surgical training, and resource investment. Regional benchmarking highlights the importance of uniform procedures and cooperative quality improvement.

Keywords: Laparoscopic, open, cholecystectomy, conversion rate, gallbladder wall, risk factors.

Citation:

Dr. Raad Fadhel Al Rubaey, Comparative Analysis Of Iraq And Neighboring Countries’ Conversion Rates From Laparoscopic To Open Cholecystectomy. Japanese Journal of Gastroenterology 2025.