1 Jan 2012Article
Can laparoscopic cholecystectomy be safety performed in the elderly?
Pietro Caglià 1Salvatore Costa 1Angelo Tracia 1Massimiliano Veroux 1Salvatore Luca 2Elisa Zappulla 1Viviana Russo 1Bibiana Lucifora 1
Affiliations
Article Info
1 Department of Surgical Sciences, Organ Transplantation and Advanced Technologies, Surgery Oncology Unit, University of Catania, Italy
2 Department of Surgery, Geriatrics Unit, University of Catania, Italy
Ann. Ital. Chir., 2012, 83(1), 21-24;
Published: 1 Jan 2012
Copyright © 2012 Annali Italiani di Chirurgia
This work is licensed under a Creative Commons Attribution 4.0 International License.
Abstract
AIM: To assess the suitability of laparoscopic cholecystectomy in elderly patients, although early reports have questioned the efficacy of this procedure in that patient group. MATERIAL OF STUDY: Retrospective study evaluating the medical records of the elderly patients who underwent laparoscopic cholecystectomy in our surgical unit. Data included age and gender, American Society of Anesthesiologists (ASA) score, comorbid illness, prior abdominal surgery, presentation, operative time, conversion rate, postoperative morbidity, and mortality rates and length of hospital stay. RESULTS: Fifty consecutive patients age 70 or older who underwent laparoscopic cholecystectomy were studied. Postoperative complications occurred in five patients. DISCUSSION: Many Studies have shown that the incidence of complicated gallstone disease in the elderly is higher when compared with that of younger patients and gallbladder disease is particularly virulent in the elderly, with high rate of acute cholecystitis, biliary tract disease, increased morbidity, and prolonged hospital stay. This poor outcome has been attributed to the presence of severe co-morbid factors associated with the aging process. Compared to open cholecystectomy, laparoscopic cholecystectomy may cause less postoperative depression of respiratory function and cell-mediated immunity. In our study perioperative mortality rate was 0%. CONCLUSIONS: Laparoscopic cholecystectomy in elderly patients is a relatively safe procedure that can be accomplished with acceptable low morbidity. In this series of geriatric patients, there was no evidence of any increased risk for conversion to an open cholecystectomy, delayed recovery, or prolonged hospitalization.
Keywords
- Comorbid condition
- Elderly patients
- Laparoscopic cholecystectomy