Abstract:

Laparoscopic cholecystectomy (LC) is used the gold standard treatment for gall bladder disease. However, some cases merit converting to open cholecystectomy. Reasons for conversion include acute cholecystitis and advanced age. In this study, we aimed to systematically assess factors that increase the likelihood of conversion. We assessed age and gender as well as preoperatively noted leukocyte counts (WBC), aspartate aminotransferase (AST), alanine aminotransferase (ALT) and bilirubin, total and direct, levels; and gall bladder wall thickness of patients diagnosed with cholelithiasis. Patients were split into two groups: the open cholecystectomy group and the LC group. We then performed a comparative analysis between these two patient groups.      We determined that these groups showed no significant difference regarding gender (p = 0,152). Moreover, the conversion rate was significantly higher in older patients (p = 0,039), and increased gall bladder wall thickness and common bile duct diameter also enhanced the conversion rate (p < 0,001 and p = 0,015). In addition, open cholecystectomy patients had higher ALT and total and direct bilirubin levels than LC patients (p = 0,014, p < 0,001 and p < 0,001, respectively). However, WBC, AST levels, and stone sizes were not significantly different between patient groups (p = 0,177, p = 0,210 and p = 0,180, respectively). In summary, we found that increased wall thickness and common bile duct diameter led to acute cholecystitis in elderly patients and enhanced the risk of conversion.

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