Laparoscopic cholecystectomy in elderly patients: Avoid or expedite? - A comparative cohort study

Area of Science:

• Surgical Gastroenterology
• Geriatric Surgery
• Minimally Invasive Surgery

Background:

• Laparoscopic cholecystectomy (LC) is the standard treatment for gall bladder stones (GBS).
• Concerns exist regarding the safety and outcomes of LC in elderly patients (≥70 years).

Purpose of the Study:

• To compare the outcomes of LC in patients aged 70 and older versus younger patients.
• To assess the safety and efficiency of LC in the elderly population.

Main Methods:

• Retrospective analysis of 548 patients undergoing LC.
• Categorization of patients into elderly (≥70 years) and younger (<70 years) groups.
• Evaluation of post-operative complications using Clavien-Dindo (CD) classifications and CEPOD criteria.

Main Results:

• Elderly patients had higher rates of emergency admission for GBS, emergency LC, and conversion to open surgery.
• Overall post-operative complication rates (bile leak, collection, re-operation, pancreatitis, death) were comparable between groups.
• Higher rates of CD I-II complications were observed in elderly patients for both elective and emergency LC.
• CD ≥3 complications were significantly higher in elderly patients undergoing emergency LC.

Conclusions:

• Laparoscopic cholecystectomy is a safe and effective procedure for elderly patients.
• Prompt elective LC is recommended for elderly patients to mitigate risks associated with emergency surgery and reduce complication rates.