**5.1 Open cholecystectomy**

The open cholecystectomy (OC) is currently performed in cases of gallbladder cancer, Mirizzi's syndrome, choledochal cyst, and in cases of sclerotising cholangitis. The incision with its localisation must be adequate for good exploration including the use of intraoperative ultrasonography or radical procedure for cancer.

It is important to emphasise that the conversion from laparoscopic approach to open cholecystectomy is not a surgeon's failure. It seems that the risk is higher in men, patients >60 years old, obese patients, patients with cirrhosis, patients after abdominal surgery in the upper part of the abdomen, patients with severe comorbidities, in case of large gallstones, febrilities, gangrenous cholecystitis, the duration of symptoms >48 h in urgent setting [10]. For the patient's safety, the conversion may be considered in case of the surgeon's inability to perform safe complicated laparoscopic cholecystectomy [10]. However, there is no evidence that the conversion will reduce or avert the risk of biliary duct injury [11]. Conversion to open surgery is an option in any difficult case. The most important focus in a cholecystectomy is the safe removal of the gallbladder and the avoidance of bile duct injuries.
