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Laparoscopic cholecystectomy in patients aged 80 years and over
1Department of Surgery, Kansai Medical University, 10-15 Fumizono, Moriguchi, Osaka, 570-8507, Japan. kon@takii.kmu.ac.jp
Introduction:
The aging population has led to a significant rise in the number of patients undergoing operations such as cholecystectomy. We have evaluated and compared the results of laparoscopic cholecystectomy (LC) in patients aged 80 years and over with those of patients aged between 65 and 79 years.
Methods:
A total of 471 patients aged 65 to 79 years (group 1) and 45 patients aged>or=80 years (group 2) underwent LC. All patients underwent preoperative spiral computed tomography after intravenous infusion cholangiography and intraoperative cholangiography.
Results:
There was a higher incidence of choledocholithiasis and gallbladder cancer in the patients>or=80 years of age. In addition, group 2 patients had a higher incidence of cardiopulmonary disease and higher American Association of Anesthesiology scores than did those in group 1. With respect to the conversion rate to open surgery, morbidity, mortality, and length of hospital stay, there were no significant differences between the two groups. There was a significantly higher incidence of positive bile cultures and gram-negative rods in group 2 patients than in those in group 1.
Conclusions:
Octogenarians tolerated LC well. Therefore, early elective LC should be encouraged to minimize morbidity and mortality in these elderly patients who have symptomatic cholelithiasis.
