Conversion to open surgery in the era of laparoscopic cholecystectomy: Changing rates and reasons in geriatric patients

Abstract

Recep Aktimur, Ali Kagan Gokakin, Koksal Deveci, Mustafa Atabey

Objective: Compared to open surgery; laparoscopic cholecystectomy has become the standard of care for the treatment of cholelithiasis at any age over the last two decades. In the present study, the aim was to identify and to compare the rates and reasons involved in conversion to open procedure in elective surgery for cholelithiasis in geriatric patients over the course of fourteen years. Methods: To assess the possible differences in the conversion rates and reasons over time, 207 patients over 65 years of age undergoing elective laparoscopic cholecystectomy for chronic cholecystitis were analyzed in two groups - the first ten years (n=141) and the last four years (n=66). Acute cholecystitis, gallbladder malignancy and/or polyps were excluded. Demographic characteristics, comorbidities, history of previous abdominal surgery, preoperative endoscopic retrograde cholangiopancreatography (ERCP) and the reasons and rates involved in conversion to open cholecystectomy were all analyzed.

Results: In male and female patients, the conversion rate was 18.8% and 5.07 %, respectively (p=0.02).  There was a significant difference in the immunolabeling of all markers between normal mucosa difficult cholecystectomies