الفهرس 
DedicationOnly 14 pages are availabe for public view
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Abstract
with decreased postoperative pain, earlier oral intake,shorter hospital stay, early resumption of normal activity and improved comesis, laparoscopic cholevcytectomy (lc) has become a routine surgical procedure in general surgical units for cholelithiasis all over the world.but, substantial proportions of patients in whom lc cannot be successfully carried out are converted to open cholecystectomy (oc) because of technical difficulty or intraoperative complications. the intent of this study was to define the role of (oc) in the era of (lc). in the period of april 2011 to October 2011 laparoscopic cholecystectomy was attempted in 75 patients suffering from symptomatic cholelithiasis a retrospective analysis of parameters, including patient demographics, laboratory values, radiologic data, and intraoperative findings, was performed
univariate and multivariate analysis was done to determine the role of (oc) in the era of (lo). sex(8.0%) patients reqired a conversion were the role of (oc) in the era of (lc). significant causes of conversion to open cholecystectomy in univariate analysis were increasing age, male gender, previous upper abdominal or upper plus lower abdominal incins, an elevated white blood cell count,preoperative ultrasound findings of a thickened gallbladder wall >4mm, preoperative endoscopic retrograde cholangiopancreatography(ercp),high-grade adhesion, and thickened wall of the gallbladder intraoperatively. multivariate analysis revealed that the significantly independent causative factors for conversion were age, male gender, total leucocytic count, gallbladder wall thickening reported by the radiologist and adlhesion score.