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Surgery for gallstones in the elderly

¹Division of Surgery, Royal Brisbane Hospital, Queensland, Australia.

The Australian and New Zealand Journal of Surgery

|May 1, 1995

Summary

Elderly patients over 65 can safely undergo laparoscopic cholecystectomy for gallstones, with high success rates. Careful pre-operative evaluation is crucial, especially for potential common bile duct stones.

Area of Science:

Gastroenterology
Surgical Oncology
Geriatric Surgery

Background:

Gallstone disease frequently affects the elderly population.
Surgical management of gallstones in older adults requires careful consideration of risks and benefits.

Purpose of the Study:

To evaluate the safety and efficacy of cholecystectomy in patients aged over 65.
To compare outcomes of laparoscopic versus open cholecystectomy in the elderly.

Main Methods:

Retrospective analysis of 349 consecutive gallstone surgery patients.
Specific focus on 66 patients aged over 65, comparing laparoscopic and open cholecystectomy outcomes.

Main Results:

Laparoscopic cholecystectomy was successful in 84% of elderly patients.

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Dense adhesions were the primary reason for conversion from laparoscopic to open surgery.

No operative mortality was observed; morbidity was similar between laparoscopic and open procedures.

Conclusions:

Laparoscopic cholecystectomy is a safe and effective option for most elderly patients with gallstones.
Pre-operative identification of common bile duct stones is essential, as they occurred in 18% of elderly patients.