Comparative Analysis of Iraq and Neighboring Countries' Conversion Rates from Laparoscopic to Open Cholecystectomy

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, intraoperativedifficulties sometimes call for conversion, which affects patient outcomes and healthcare expenses. Comparative regional dataare 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 thosefrom nearby nations to provide context for results and call attention to surgical opportunities.Materials and Methods: This retrospective cohort study was conducted from September 2020 to April 2024 on 880 patientsundergoing LC for symptomatic cholelithiasis at three main hospitals in Hilla, Iraq. Hospital records were mined for patientdemographics, surgical specifics, and the causes of conversion. Using descriptive statistics and multivariate logistic regression,conversion rates and risk variables including age, sex, and gallbladder wall thickness were examined. By employing harmonicdefinitions and statistical techniques, comparative data from recent regional investigations (2010 to 2023) were rigorouslyexamined.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 higherthan 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 themost 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.