Ann Surg Treat Res.  2015 Mar;88(3):145-151. 10.4174/astr.2015.88.3.145.

Clinical outcome for laparoscopic cholecystectomy in extremely elderly patients

• Lee SI
• Na BG
• Yoo YS
• Mun SP
• Choi NK

• KMID: 2266872
• DOI: http://doi.org/10.4174/astr.2015.88.3.145

Abstract

PURPOSE
Extremely elderly patients who present with complicated gallstone disease are less likely to undergo definitive treatment. The use of laparoscopic cholecystectomy (LC) in older patients is complicated by comorbid conditions that are concomitant with advanced age and may increase postoperative complications and the frequency of conversion to open surgery. We aimed to evaluate the results of LC in patients (older than 80 years).
METHODS
We retrospectively analyzed 302 patients who underwent LC for acute cholecystitis between January 2011 and December 2013. Total patients were divided into three groups: group 1 patients were younger than 65 years, group 2 patients were between 65 and 79 years, and group 3 patients were older than 80 years. Patient characteristics were compared between the different groups.
RESULTS
The conversion rate was significantly higher in group 3 compared to that in the other groups. Hematoma in gallbladder fossa and intraoperative bleeding were higher in group 3, the difference was not significant. Wound infection was not different between the three groups. Operating time and postoperative hospital stay were significantly higher in group 3 compared to those in the other groups. There was no reported bile leakage and operative mortality. Preoperative percutaneous transhepatic gallbladder drainage and endoscopic retrograde cholangiopancreatography were performed more frequently in group 3 than in the other groups.
CONCLUSION
LC is safe and feasible. It should be the gold-standard approach for extremely elderly patients with acute cholecystitis.

Keyword

Laparoscopic cholecystectomy; 80 and over aged; Treatment outcome

MeSH Terms

Aged*
Bile
Cholangiopancreatography, Endoscopic Retrograde
Cholecystectomy, Laparoscopic*
Cholecystitis, Acute
Conversion to Open Surgery
Drainage
Gallbladder
Gallstones
Hematoma
Hemorrhage
Humans
Length of Stay
Mortality
Postoperative Complications
Retrospective Studies
Treatment Outcome
Wound Infection

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