Considerations Concerning Laparoscopic Cholecystectomy in the Extremely Elderly

Pavlidis, Theodosios; Georgios, N Marakis; Nikolaos, Symeonidis; Psarras, Kyriakos; Konstantinos, Ballas; Savvas, Rafailidis; Athanasios, Kapezanos

doi:10.1089/lap.2007.0037

Cited by 26 publications

(30 citation statements)

References 19 publications

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“…This morbidity was lower than that reported by several authors 12,[19][20][21] . The vast majority of perioperative and postoperative complications had little or no impact on the final results.…”

Section: Results Results Results Resultscontrasting

confidence: 54%

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Colecistectomia videolaparoscópica em 960 pacientes idosos

Loureiro

Klein

Pavan

et al. 2011

Rev. Col. Bras. Cir.

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Results Results: operative time ranged from nine to 180 minutes. The length of stay ranged from 24 to 120 hours. Conversion occurred in 28 patients (2.92%), of which 67.9% were women and 28.6% men, a minilaparotomy having been performed in 11 cases (39.3%) and in 17 (60.7%) the conventional open route. The perioperative complications were two ruptures of the gallbladder, a failure in the pneumoperitoneum and in clipping of the cystic duct. Post-operative complications were five umbilical incisional hernias. Systemic complications were: nine arrhythmias, one postoperative jaundice, one acute myocardial infarction and one mesenteric infarction. Mortality occurred in three patients (0.3%), one due to perioperative myocardial infarction, one due to sepsis and one because of the mesenteric infarction. Conclusion Conclusion Conclusion Conclusion Conclusion: elderly patients undergoing laparoscopic cholecystectomy had low hospital stay and low morbimortality. The operative time and hospital stay were short, demonstrating that laparoscopic cholecystectomy is safe and effective in the elderly.

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Section: Results Results Results Resultscontrasting

confidence: 54%

“…Some authors have described death rates ranging between 0% and 2%. 9,15,19,25,26 In this work, the causes were represented by three major conditions: sepsis, mesenteric infarction and myocardial infarction. The latter was also observed by Brunt et al 21 and more recently by Malik et al 10 .…”

Section: Results Results Results Resultsmentioning

confidence: 99%

Colecistectomia videolaparoscópica em 960 pacientes idosos

Loureiro

Klein

Pavan

et al. 2011

Rev. Col. Bras. Cir.

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show abstract

“…Számos tanulmány számol be arról, hogy az időskor-ban előforduló epehólyag-kövesség gyakrabban okoz heveny epehólyag-gyulladást, alakul ki biliaris pancreatitiszszel, choledocholithiasissal járó szövődményes forma, mint fiatalkorban [10,11]. Ezt igazolja anyagunk is, hiszen a 10 meghalt beteg közül 9-et már súlyos szövőd-ménnyel vettünk fel.…”

Section: Megbeszélésunclassified

A laparoszkópia szerepe a 80 évesnél idősebb betegek epekövességének megoldásában

et al. 2016

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Bevezetés: Az epehólyag-kövesség előfordulási gyakorisága az életkorral nő, azonban a 80 év feletti betegek műtétjei-nek kimeneteléről alig vannak adatok. A társadalom elöregedésével a kérdés egyre időszerűbb. Célkitűzés: A 80 éves-nél idősebb betegeknél végzett akut és elektív cholecystectomiák elemzése. Módszer: A szerzők az elmúlt hat évben a 80 évesnél idősebb, cholelithiasis miatt operált betegeknél a műtét típusát, a konverzió arányát, a szövődmények gyakoriságát, a posztoperatív mortalitást, az intenzív osztályos és kórházi ápolási napok számát vizsgálták retrospektíven. Eredmények: A vizsgált időszakban a 69 elektív, 51 akut műtétet végeztek, utóbbiak 9,8%-ánál pancreatitist, 14%-ánál májtályogot, 27%-ánál choledocholithiasist találtak. Az elektív csoport 84%-ánál, míg az akut csoport 17,7%-ánál sikerült az epehólyag laparoszkópos eltávolítása. Az intenzív osztályos 9,1 vs. 1 nap, a teljes kórházi ápo-lás 12 vs. 3,6 nap volt az akut, illetve tervezett műtétnél. A sürgősséggel operált betegeknél a mortalitás 20% és a reoperáció 16% volt, elektív betegeknél egyik sem fordult elő. Következtetések: A laparoszkópos cholecystectomia idős betegek tervezett műtéteinél kiváló eredménnyel alkalmazható, ezért cholelithiasis esetén 80 év feletti betegeknél is törekedni kell az elektív műtétre. Orv. Hetil., 2016, 157(5), 185-190. Kulcsszavak: cholecystectomia, laparoszkópia, idős, morbiditás, mortalitásThe role of laparoscopy in cholecystectomy in patients with age of 80 or above Introduction: The incidence of cholelithiasis increases with age, however, there is still little data about the outcomes of cholecystectomy in patients with age of 80 and above. Population ageing presents tremenduous challenges for surgeons. Aim: The aim of the authors was to compare emergency and elective cholecystectomies performed in these elderly patients. Method: This retrospective study was based on the analysis of operation type, conversion rate, complications, mortality, length of hospital stay of all patients over 80 who underwent cholecystectomy in the last 6 years at the 1st Department of Surgery, Semmelweis University. Results: 69 elective and 51emergency operations were performed. In the emergency group pancreatitis was found in 9.8%, liver abscess in 14%, and common bile duct stones in 27% of the patients on admission. Laparoscopic cholecystectomy could be performed in 84% of patients in the elective group, while in 17.7% of patients in the emergency group. The length of stay at the intensive care unit was 9.1 and 1 days, while the total length of hospital stay was 12 and 3.6 days for the elective and emergency groups, respectively. In the emergency group mortality was 20% and reoperation was performed in 16% of patients, while at the elective group none of these occured. Conclusion: Laparoscopic cholecystectomy is safe as elective surgery for patients with age of 80 and above. For this reason the authors recommend elective cholecystectomy in this age group.

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“…On the other hand, the rate of conversion was 6.2% in the male group and 3.3% in the female group operated upon by attending surgeons, again showing an almost double rate of conversion in the male group. Only 6 of the 59 cases converted to open surgery were younger than 50 years old [25,26] (Fig. 4).…”

Section: Rate Of Conversionmentioning

confidence: 99%