Conversion from diagnostic laparoscopy to laparotomy: risk factors and occurrence

Objective: To determine reasons for conversion from diagnostic laparoscopic procedures to celiotomy in dogs and cats. Study Design: Case series. Animals: Dogs (n=54), cats (40). Methods: Medical records (2004–2008) were reviewed for dogs and cats that had diagnostic laparoscopic or laparoscopic‐assisted biopsy. Numbers of conversions to laparotomy were recorded, including cause and type (elective versus emergent), postoperative complications, and short‐term outcome. Specific risk factors for conversion, including signalment, preoperative diagnostics, and surgical findings were assessed; categorical variables were tested by χ² and Fisher's exact tests; continuous variables by Student's t‐test and Wilcoxon's rank‐sum tests; multivariate logistic regression models were created. Results: Twenty animals (21%) had laparoscopic conversion; 13 (65%) were considered elective and 7 (35%) emergent conversions. There was no significant difference between animals requiring and those not requiring conversion for age, weight, sex, body condition score, clinical signs, previous abdominal surgery, or surgeon experience. Significant risk factors for conversion included low total solids (P=.03), presence of a solitary liver tumor (P<.01), and diagnosis of neoplasia (P<.01). Conclusions: A conversion rate of 21% was found in this population of dogs and cats undergoing laparoscopic diagnostic procedures. A preoperative finding of a solitary liver tumor, low total solids, and diagnosis of malignancy were all significant risk factors for conversion.