A Study of Laparoscopic Cholecystectomy in Patients Above and Below 50 Years of Age

Abstract

Background: Cholecystectomy is the commonest operation of the biliary tract. Laparoscopic cholecystectomy (LC) is the standard treatment of symptomatic gallbladder disease. It has numerous advantages over open cholecystectomy (OC). However, current literature suggests that rate of conversion from LC to OC is 1%-15%.Methods: This retrospective study aims to evaluate the risk factors of conversion of LC to open between the elderly (> 50 years old) and the young (≤ 50 years old) and its relation with preoperative data and intraoperative findings. A total of 120 patients, 60 in each group, over a period of January 2016 to June 2017 were studied. Results: A total of 36 cases out of 120 were converted. Of these 36, 14 were in the young age group and 22 in the elderly. In each group, majority cases who were converted, were men (P value <0.05) and duration of symptoms of more than 1 year (P value<0.001). There was highly significant difference seen in the cases converted in the young age group and comorbidities (P value<0.001). Of all the converted cases, a highly significant difference was seen in both age groups with adhesions, intrahepatic and gangrenous gall bladder Conclusion: We believe this is the first study in a developing country like ours suggesting laparoscopic cholecystectomy is a safe procedure irrespective of the age of the patient. While in fact, it is the chronicity of the symptoms, the gender and the intraoperative findings which predict and mandate the conversion of LC to OC.