Laparoscopic Cholecystectomy for Acute Cholecystitis in the Elderly

This study reviewed the results of laparoscopic cholecystectomy for acute cholecystitis in the elderly. Among 557 patients who underwent laparoscopic cholecystectomy, 70 (12.6%) had a clinical diagnosis of acute cholecystitis confirmed by ultrasonography. There were 28 men and 42 women with a mean a...

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Bibliographic Details
Published in:World journal of surgery 1996-10, Vol.20 (8), p.983-987
Main Authors: Lo, Chung‐Mau, Lai, Edward C.S., Fan, Sheung‐Tat, Liu, Chi‐Leung, Wong, John
Format: Article
Language:English
Subjects:
Acute Cholecystitis
Acute Disease
Adult
Aged
Aged, 80 and over
Cholangiopancreatography, Endoscopic Retrograde
Cholecystectomy, Laparoscopic - methods
Cholecystitis
Cholecystitis - diagnosis
Cholecystitis - surgery
Common Bile Duct - diagnostic imaging
Elderly Patient
Female
Humans
Laparoscopic Cholecystectomy
Length of Stay
Male
Middle Aged
Retrospective Studies
Total Hospital
Treatment Outcome
Ultrasonography
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Summary:This study reviewed the results of laparoscopic cholecystectomy for acute cholecystitis in the elderly. Among 557 patients who underwent laparoscopic cholecystectomy, 70 (12.6%) had a clinical diagnosis of acute cholecystitis confirmed by ultrasonography. There were 28 men and 42 women with a mean age of 59.9 years (range 20–87 years). Thirty patients ≥ 65 years of age were compared to 40 patients < 65 years old. Elderly patients had a higher female predominance (p< 0.05), a higher incidence of intercurrent diseases (p< 0.05), and a higher serum urea level (p< 0.001). The proportions of patients who underwent early or delayed surgery were comparable. There was no difference in operation time, postoperative analgesic requirements, or complications. Elderly patients, however, had a significantly higher conversion rate (23.3% versus 2.5%;p< 0.05). Even after successful laparoscopic cholecystectomy, there was a longer delay before ambulation (p< 0.05) and resumption of normal diet (p= 0.08) with resulting prolonged postoperative (p= 0.08) and total hospital stay (p< 0.05). Laparoscopic cholecystectomy is a safe, effective treatment for acute cholecystitis in the elderly. When compared to younger patients, elderly patients are at greater risk for conversion, delayed recovery, and prolonged hospital stay.
ISSN:0364-2313
1432-2323
DOI:10.1007/s002689900148