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Laparoscopic cholecystectomy in elderly patients: an evaluation of immunity
Hong-Qiang Zhao1,2, Hao-Run Liu2, Li Xiao3
1Medical School of Chinese People's Liberation Army, Haidian district, Beijing, 100853, China.
Insights
Elderly patients exhibit a diminished inflammatory and immune response to laparoscopic cholecystectomy (LC), suggesting increased surgical risk. Further research is needed to confirm these findings for aged individuals undergoing LC.
Area of Science:
- Surgical immunology
- Geriatric surgery
- Inflammatory response
Background:
- Laparoscopic cholecystectomy (LC) is a common procedure for gallstones.
- Age-related changes can impact surgical outcomes and immune function.
Purpose of the Study:
- To compare the impact of LC on inflammatory and immunological responses in elderly versus younger patients.
- To identify potential age-related differences in perioperative immune function.
Main Methods:
- A prospective study of 112 patients undergoing LC, divided into elderly (>65 years) and younger groups.
- Analysis of peripheral venous blood samples pre-surgery and on post-operative days 1, 3, and 7.
- Comparison of perioperative clinical outcomes and immunological markers between age groups.
Main Results:
- Elderly patients experienced longer operating times, hospital stays, and higher complication rates.
- Both groups showed altered inflammatory and immune markers post-LC.
- Elderly patients had fewer preoperative immune cells, delayed immune responses, and a hyporeactive inflammatory response compared to younger patients.
Conclusions:
- Significant age-related differences exist in inflammatory and immune responses following LC.
- Elderly patients demonstrate a blunted immune and inflammatory reaction to LC.
- Further investigation with larger cohorts is necessary to correlate perioperative immune changes with adverse outcomes in older adults.
Objective:
We sought to investigate the impact of laparoscopic cholecystectomy (LC) on the inflammatory response and immunological function of elderly patients compared with that on the younger ones.
Methods:
Between June 2012 and June 2013, this prospective study investigated a total of 112 patients having the surgery of LC due to symptomatic cholelithiasis or polyps, among whom 52 were elderly patients with the age beyond 65 years old and the remaining 60 were younger than the age. Peripheral venous blood samples were taken from these patients prior to surgery and on post-operative days 1, 3 and 7, respectively. The perioperative clinical outcomes and immunological function results were analyzed and compared between the two groups divided by age.
Results:
The demographics of the two groups did not differ except for the age. Surgical trauma seemed more serious for elderly patients as illustrated by the longer operating time, hospital stay and more quantity of patients got complication. Both groups indicated changes in inflammatory and immune aspects. Compared with the younger ones, elderly patients showed less quantity of preoperative basic immune cells, delayed immune responses after the surgical trauma of LC and hyporeactivity of inflammatory response when accepting LC.
Conclusions:
An examination of the inflammatory reaction and immune response after LC demonstrated that there are significant differences observed in two groups divided by age. Further studies with more samples are required to determine the exact relationship of perioperative immune change and higher adverse outcome rate of aged people.
