Abstract
Background Laparoscopic cholecystectomy (LC) is the standard procedure for the management of symptomatic gallbladder disease, offering numerous benefits such as reduced pain and faster recovery compared to open surgery. Objective This study aimed to determine the incidence and types of postoperative complications and assess factors associated with conversion to open surgery in patients undergoing LC. Methods This is a retrospective cohort study, conducted at Shalamar Hospital, Lahore, Pakistan, from June 2023 to June 2025. A total of 355 patients who underwent the procedure were included in the study using a non-probability consecutive sampling technique. Data were collected retrospectively from the hospital's surgical database and patient medical records. Information on patient demographics, comorbidities, surgical details, postoperative complications, and conversion rates was extracted for analysis. Results Among 355 patients (mean age: 48.3 ± 12.7 years; 67% women), 43 patients (12%) developed postoperative complications. The most common were surgical site infection (5%) and bile duct injury (2.5%). The overall conversion rate was 3.4%, higher in emergency (9.3%) compared to elective (2.2%) procedures. Logistic regression showed significant associations between postoperative complications and obesity (odds ratio {OR}, 3.5; 95% confidence interval {CI}, 1.5-8.2; p = 0.002), emergency surgery (OR, 2.1; 95% CI, 1.2-3.6; p = 0.008), and diabetes (OR, 2.3; 95% CI, 1.1-4.8; p = 0.03). Conversion was significantly associated with acute cholecystitis (OR, 4.1; p = 0.002), previous abdominal surgery (OR, 4.2; p = 0.01), obesity (OR, 3.3; p = 0.004), and emergency surgery (OR, 2.3; p = 0.04). Conclusion Laparoscopic cholecystectomy is a safe and effective procedure with low complication and conversion rates. Obesity, diabetes, and emergency presentation were significantly associated with adverse outcomes, underscoring the need for careful patient selection, preoperative optimization, and timely elective surgery. These associations should be confirmed through future prospective studies.