[Clinical aspects and therapy of cholelithiasis in elderly patients]

The article analyses the results of surgical treatment of 110 patients aged over 70 with acute cholecystitis. All of them underwent cholecystectomy with intraoperative cholangiography: choledocholithiasis was found in 26.4% and stricture of the distal choledochus in 10.0% of cases. Postoperative complications developed in 19% of patients, the mortality rate was 5.45%. Simultaneously, 72 elderly and old-aged patients were operated on for chronic calculous cholecystitis after thorough examination and preoperative management. Postoperative complications occurred in 13.9% of cases, none of the patients died. The authors conclude that in adequate preoperative management, careful choice of the method of anesthesia, and substantiated postoperative management, cholecystectomy is the operation of choice in acute calculous cholecystitis in patients over 70 years of age. Planned operations are very advisable in chronic calculous cholecystitis in patients of this age group for the prevention of severe complications, if adequate treatment of concomitant diseases is applied.