Factors associated with prolonged stay after laparoscopic cholecystectomy in elderly patients

Shahi

Surgery Research and Practice

et al. 2017

Background The incidence of gallstone increases with increasing age. No studies have been reported in the elderly population with laparoscopic cholecystectomy from developing nations. The aim of this study was to compare perioperative outcomes of laparoscopic cholecystectomy between the elderly (≥60 years old) and the young (<60 years old). Methods From July 2015 to June 2016, a retrospective review of medical records of 78 elderly patients (≥60 years old) and 164 young patients (<60 years old) who underwent laparoscopic cholecystectomy was done. The patients' demographics and perioperative outcomes were analyzed. Results Median ages were 65 years (range: 60–80) and 45 years (range: 21–59) for the elderly group and the young group. The majority of patients were female (62.8 and 72%). There were no significant differences in the conversion rate (9 and 7.9%, P = 0.78), postoperative complications (17.9 and 14.6%, P = 0.50), and length of stay in the hospital (4 days for both groups, P = 0.35) between the two groups. There was no mortality in either of the groups. Conclusion Our results of laparoscopic cholecystectomy in elderly patients are comparable with those in young patients. Therefore, laparoscopic cholecystectomy is safe even in the elderly population.

Section: Discussionsupporting

confidence: 91%

Laparoscopic Cholecystectomy in the Elderly: An Experience at a Tertiary Care Hospital in Western Nepal

Shahi

Surgery Research and Practice

et al. 2017

“…In this work, the average surgical time of 44.22 minutes can be considered low compared to most recent publications [8][9][10] . This value tends to decrease with surgeon experience, surgical team joint working time and with the systematization of the technique.…”

Section: Results Results Results Resultsmentioning

confidence: 82%

“…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.

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.

“…The prevalence of gallstones increases with age in both sexes and in nearly all populations; in older individuals the prevalence ranges from 20% to 30% and increases to 80% for institutionalized patients older than 90 years [1,2,3]. Since the introduction of laparoscopic cholecystectomy (LC) nearly two decades ago, and the more recent use of it as an outpatient procedure, many surgeons now view cholecystectomy as a relatively simple procedure from which patients recover quickly [4].…”

Section: Introductionmentioning

confidence: 99%

Clinical outcome for laparoscopic cholecystectomy in extremely elderly patients

Lee

Yoo

et al. 2015

Ann Surg Treat Res

PurposeExtremely elderly patients who present with complicated gallstone disease are less likely to undergo definitive treatment. The use of laparoscopic cholecystectomy (LC) in older patients is complicated by comorbid conditions that are concomitant with advanced age and may increase postoperative complications and the frequency of conversion to open surgery. We aimed to evaluate the results of LC in patients (older than 80 years).MethodsWe retrospectively analyzed 302 patients who underwent LC for acute cholecystitis between January 2011 and December 2013. Total patients were divided into three groups: group 1 patients were younger than 65 years, group 2 patients were between 65 and 79 years, and group 3 patients were older than 80 years. Patient characteristics were compared between the different groups.ResultsThe conversion rate was significantly higher in group 3 compared to that in the other groups. Hematoma in gallbladder fossa and intraoperative bleeding were higher in group 3, the difference was not significant. Wound infection was not different between the three groups. Operating time and postoperative hospital stay were significantly higher in group 3 compared to those in the other groups. There was no reported bile leakage and operative mortality. Preoperative percutaneous transhepatic gallbladder drainage and endoscopic retrograde cholangiopancreatography were performed more frequently in group 3 than in the other groups.ConclusionLC is safe and feasible. It should be the gold-standard approach for extremely elderly patients with acute cholecystitis.