Cholecystectomy in high risk patients

Two hundred and seventy two patients with one or more associated preoperative high risk factors underwent cholecystectomy in the Department of Surgical Gastroenterology, SGPGIMS, Lucknow, between December 89 and November 95. The identified risk factors were advanced age (> 65 years), cardiac diseases, endocrine disorders, respiratory diseases and others. Fifty patients (18%) had two and 6 patients (2.2%) had three risk factors each. During the same period, 1006 patients with no risk factors had simple cholecystectomy done in the department. The morbidity and mortality of cholecystectomy in the high risk group was 27% and 0.4% respectively, and in the group with no risk factors 14% and 0.2% respectively. The morbidity and mortality in the high risk group was significantly greater than that in the no risk group. It is suggested that with good preoperative evaluation close intraoperative monitoring and intensive postoperative care, these figures could be reduced further.