Is conversion the only itinerary to peace with "hostile" laparoscopic cholecystectomy?

Laparoscopic cholecystectomy (LC) remains the most common surgical procedure worldwide. With these unequivocal benefits, it is today the optimal standard of care for symptomatic cholelithiasis. However, this routine operation can also represent one of the most "hostile" situations. In scenarios of uncertain Critical View of Safety display, total cholecystectomy and laparoscopic approach incur a risk of serious complications such as iatrogenic bile duct injury (IBDI). In such situations, it is necessary to improvise an approach different from the traditional concepts used for elective cases and provide a rescue plan that promotes safety. Although the balance between maintaining LC and moving to an exit procedure is resolved, it remains a challenge for providers to navigate the best alternative strategy. The truth in this debate of seeking optimal results is that surgeons are inclined to resort to conversion, as the most usual itinerary. However, it is inconsistent to consider that the simple fact of switching to an open procedure necessarily protects against IBDI, as well as to approve the conversion as a single manifest alternative to cope without knowing the other saviors procedures and their profiles. Therefore, we found it very useful to compile research data regarding "hostile" CL bailout methods to optimize their use in our practice and to answer the question which strategy to choose? And why?