Laparoscopic Cholecystectomy in Patients Aged 80 Years and Older

Peker, Yasin; Ünalp, Haluk Recai; Durak, Evren; Karabuğa, Türker; Yılmaz, Yakup; Genç, Hüdai; Hacıyanlı, Mehmet

doi:10.1097/sle.0b013e31828f6be4

Cited by 19 publications

(10 citation statements)

References 15 publications

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“…The incidence of choledocholithiasis increases with age and the overall risk is higher in elderly patients with severe comorbidities like in our study [19][20][21].…”

Section: Discussionsupporting

confidence: 61%

The Role of Laparoscopic Ultrasonography in the Evaluation of Suspected Choledocholithiasis. A Single-Center Experience

et al. 2020

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Background and objectives: Opinions differ regarding the optimal diagnostic methods for patients with suspected choledocholithiasis. The aim of this study was to assess the diagnostic accuracy of laparoscopic ultrasonography (LUS) and compare it to pre-operative magnetic resonance cholangio-pancreatography (MRCP); Materials and Methods: In all patients with suspected choledocholithiasis LUS was performed during laparoscopic cholecystectomy to evaluate biliary stones. According to availability, part of the patients had pre-operative MRCP. Data for diagnostic accuracy and main outcomes were collected prospectively and analyzed retrospectively; Results: Choledocholithiasis was detected in 178 of 297 patients by LUS (59.93%) and in 39 of 87 patients by MRCP (44.8%), p = 0.041. LUS yielded a sensitivity of 99.4%, a specificity of 94.3%, a positive predictive value of 96.1% and a negative predictive value of 99.1%. However, pre-operative MRCP had a sensitivity of 61.7%, a specificity of 92.3%, a positive predictive value of 94.9% and a negative predictive value of 51.1%. Moreover, of the 47 patients with no choledocholithiasis by MRCP, in 23 cases it was later detected by LUS (a false negative MRCP finding—38.3%), p < 0.001. Median duration of hospitalization was significantly shorter in patients evaluated without pre-operative MRCP—8 days (interquartile range – IQR 11–6) vs. 11 days (IQR 14–9), p = 0.001; Conclusions: LUS may reduce the role of pre-operative MRCP and can become a rational alternative to MRCP as a primary imaging technique for the detection of choledocholithiasis.

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“…The incidence of choledocholithiasis increases with age and the overall risk is higher in elderly patients with severe comorbidities like in our study [19][20][21].…”

Section: Discussionsupporting

confidence: 61%

The Role of Laparoscopic Ultrasonography in the Evaluation of Suspected Choledocholithiasis. A Single-Center Experience

et al. 2020

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“…Some studies suggested that laparoscopic cholecystectomy should be the first line approach in specific categories of patients such as the elderly or pregnant women [ 102 , 103 ]. According to meta-analysis published by de Goede et al, elective laparoscopic cholecystectomy in patients with Child A or B cirrhosis is associated with significantly less postoperative complications, shorter duration of hospitalization and shorter time to resume normal diet compared to open technique [ 104 ].…”

Section: Resultsmentioning

confidence: 99%

2016 WSES guidelines on acute calculous cholecystitis

et al. 2016

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Acute calculus cholecystitis is a very common disease with several area of uncertainty. The World Society of Emergency Surgery developed extensive guidelines in order to cover grey areas. The diagnostic criteria, the antimicrobial therapy, the evaluation of associated common bile duct stones, the identification of “high risk” patients, the surgical timing, the type of surgery, and the alternatives to surgery are discussed. Moreover the algorithm is proposed: as soon as diagnosis is made and after the evaluation of choledocholitiasis risk, laparoscopic cholecystectomy should be offered to all patients exception of those with high risk of morbidity or mortality. These Guidelines must be considered as an adjunctive tool for decision but they are not substitute of the clinical judgement for the individual patient.

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“…Некоторые исследования показали, что лапароскопическая холецистэктомия должна быть операцией выбора у определенных категорий пациентов, таких как пожилые люди или беременные женщины [102,103]. Согласно метаанализу, опубликованному B. de Goede и соавт., плановая лапароскопическая холецистэктомия у пациентов с циррозом печени класса А и В по Чайлд-Пью ведет к значительно меньшему количеству послеоперационных осложнений, уменьшению длительности госпитализации и более быстрому возвращению к полноценному питанию по сравнению с открытой операцией [104].…”

Section: утверждение 63 среди пациентов с высоким риском -при наличunclassified

“…Some studies suggested that laparoscopic cholecystectomy should be the first line approach in specific cat-egories of patients such as the elderly or pregnant women [102,103]. According to meta-analysis published by de Goede et al, elective laparoscopic cholecystectomy in patients with Child A or B cirrhosis is associated with significantly less postoperative complications, shorter duration of hospitalization and shorter time to resume normal diet compared to open technique [104].…”

Section: Statement 63 Among High-risk Patients In Those With Child mentioning

confidence: 99%

2016 WSES guidelines on acute calculous cholecystitis

Ansaloni¹,

Pisano²,

Coccolini³

et al. 2017

Endosk. khir.

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Острый калькулезный холецистит является очень распространенным заболеванием, с которым связаны определенные неясности. Для того чтобы устранить эти белые пятна, Всемирное общество неотложной хирургии (World Society of Emergency Surgery-WSES) разработало подробные рекомендации. Обсуждены диагностические критерии, антибактериальная терапия, вид хирургического вмешательства и альтернативы хирургическому пособию. Более того, предложен алгоритм действий при установлении диагноза «острый калькулезный холецистит»: после оценки риска холедохолитиаза следует предлагать выполнение лапароскопической холецистэктомии всем пациентам за исключением имеющих высокий риск осложнений и смерти. Данные рекомендации следует рассматривать в качестве дополнительного инструмента для принятия решения, они не заменяют клинического суждения врача относительно каждого конкретного пациента. Ключевые слова: острый калькулезный холецистит, диагноз, холецистэктомия, камни желчевыводящих путей, хирургический риск, чрескожное дренирование желчного пузыря, эндоскопическая ультрасонография, магнитный резонанс, антибиотик, абдоминальная инфекция.

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Laparoscopic Cholecystectomy in Patients Aged 80 Years and Older

Abstract: LC in octogenarians is a relatively safe procedure that can be performed with low morbidity and mortality rates. The comorbidities and higher ASA scale are major risk factors for postoperative complications in this age group of patients.

Cited by 19 publications

References 15 publications

The Role of Laparoscopic Ultrasonography in the Evaluation of Suspected Choledocholithiasis. A Single-Center Experience

The Role of Laparoscopic Ultrasonography in the Evaluation of Suspected Choledocholithiasis. A Single-Center Experience

2016 WSES guidelines on acute calculous cholecystitis

2016 WSES guidelines on acute calculous cholecystitis

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