Laparoscopic Cholecystectomy in Elderly Patients

Author： Yetkin Gurkan Uludag Mehmet Oba Sibel Citgez Bulent Paksoy Inci

Publisher： Society of Laparoendoscopic Surgeons

ISSN： 1086-8089

Source： JSLS, Journal of the Society of Laparoendoscopic Surgeons, Vol.13, Iss.4, 2009-10, pp. : 587-591

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Abstract

Background and Objective: In this study, we investigated whether laparoscopic cholecystectomy, a minimally invasive procedure, is advantageous in elderly patients.Methods: Data from 595 patients who underwent laparoscopic cholecystectomy between January 2003 and December 2007 were prospectively collected in a database. The patients were separated into 2 groups; patients >70 years of age (group A), and patients <70 years of age (group B). Group A was further divided into 3 subgroups, ages 70 to 74, 75 to 79, and 80 and above. Comparison between the groups was made with Mann-Whitney U and chi-square tests where appropriate.Results: ASA scores increased in conjunction with increased age (P<0.001). Of patients with an operative time longer than one hour, 26 patients aged 70 or older, and 152 patients aged 69 or younger had no difference with respect to PaCO₂ and pH measurements (P>0.05). In patients aged 80 or older, the rates of acute cholecystitis, conversion to open surgery, and postoperative complications were significantly higher than in other groups (P>0.05).Conclusion: We believe that in elderly patients, laparoscopic surgery can be applied safely without further increasing the surgical risks. The complications can be minimized by carefully selecting the patients aged 80 or older and by experienced teams with high technical capabilities operating on such patients.