To investigate the risk factors of conversion from laparoscopic cholecystectomy(LC) to open cholecystectomy(OC) for moderate (level Ⅱ) acute cholecystitis based on Tokyo guidelines (2018).

The data of 137 patients with acute cholecystitis from January 2014 to January 2016 were retrospectively analyzed. LC was performed in 57 patients, and conversion from LC to OC was performed in 80 patient, which were divided into LC group and Conversion group. Data were processed by SPSS13.0 statistical software. Measuring data were expressed as (mean±SD) and tested for the normality of variables. Variables did not pass the normality test were expressed as median (quartile spacing) and rank sum test was performed. Logistic regression analysis was used for multivariate analysis, (P<0.05) was statistically significant and the independent risk factors affecting conversion were determined.

(1) The risk factors of conversion to OC for moderate (level Ⅱ) acute cholecystitis were analyzed by single factor analysis. The results showed that age, frequency of seizures, white blood cell count, patient’s highest body temperature, gallbladder thickness and gallbladder size in the Conversion group were significantly higher than those in the LC group (P<0.05). The seniority of surgeon in the Conversion group was significantly lower than that in the LC group (P<0.05). Multivariate analysis showed that the frequency of seizures and the highest body temperature of patients were independent risk factors for conversion to OC, and the seniority of surgeon was an independent protective factor for conversion to OC.

The frequency of seizures and the highest body temperature of patients are independent risk factors for conversion to OC for moderate (level Ⅱ) acute cholecystitis. Experienced surgeons can reduce the probability of conversion to OC in such diseases.