Laparoscopic cholecystectomy in the elderly

Background/PurposeClinical outcomes of octogenarians with acute cholecystitis treated with laparoscopic cholecystectomy are unclear. This study aimed to compare their outcomes according to preoperative severity and comorbidities.MethodsMedical charts of 120 octogenarians who underwent laparoscopic cholecystectomy for acute cholecystitis between January 2008 and December 2017 at Asan Medical Center, Seoul, Korea, were retrospectively reviewed. Based on the Tokyo Guidelines 2018 (TG 18), patients had mild (n = 35), moderate (n = 61), or severe (n = 24) disease. We investigated postoperative outcomes, comorbidities, and prognostic factors of ≥grade III complications.ResultsTotal antibiotic use duration (P = .024), operative times (P = .002), additional port insertion (P = .012), and postoperative hospital stay (P = .018) were significantly higher in the severe group. There were no statistically significant differences in total or grade III or higher complications (P = .304) or mortality (P = .476). On multivariate analysis, pulmonary disease predicted Clavien‐Dindo classification ≥grade III complications (odds ratio 37.075; 95% confidence interval 5.734‐239.695; P < .001).ConclusionsIn octogenarians, laparoscopic cholecystectomy is feasible and tolerable for severe acute cholecystitis classified according to the TG 18. Pulmonary comorbidities are an independent prognostic factor of ≥grade III complications.

show abstract

Nichtonkologische Viszeralchirurgie im Alter

Gassel

Meyer²,

Sailer³

et al. 2005

Chirurg

View full text Add to dashboard Cite

Due to rising life expectancy of the population, the proportion of elderly patients requiring surgery is rising as well. Present aspects of selected, typical, nononcologic diseases of elderly people are discussed. The key to success in their treatment is not to consider primarily the patient's calendrical age but to assess the individual profile of risk factors on the basis of comorbidities. The kind, extent, and timing of an operation has to be based on this assessment. For the treatment of acute diseases (e.g., complicated ulcera, cholecystitis, appendicitis, mesenteric ischemia, and diverticulitis), a rapid and efficacious diagnostic algorithm is essential that takes into account the reduced functional reserve of old people. Constructive interdisciplinary cooperation and minimally invasive techniques play dominant roles in both diagnosis and therapy. Given these prerequisites, there is no reason to withhold surgical intervention from elderly patients.

show abstract

scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.

Contact Info

customersupport@researchsolutions.com

10624 S. Eastern Ave., Ste. A-614

Henderson, NV 89052, USA

This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.

Blog Terms and Conditions API Terms Privacy Policy Contact Cookie Preferences Do Not Sell or Share My Personal Information

Made with 💙 for researchers

Part of the Research Solutions Family.

Laparoscopic cholecystectomy in the elderly

Abstract: Our results in this pilot study suggest that remote-access endoscopic telemanipulation can execute complex three-dimensional manipulations, and that the intuitive orientation of the surgeon's workstation may contribute to easier task completion.

Cited by 36 publications

References 32 publications

Multicentre study of the safety of laparoscopic subtotal gastrectomy for gastric cancer in the elderly

Multicentre study of the safety of laparoscopic subtotal gastrectomy for gastric cancer in the elderly

Clinical outcomes of octogenarians according to preoperative disease severity and comorbidities after laparoscopic cholecystectomy for acute cholecystitis

Nichtonkologische Viszeralchirurgie im Alter

Contact Info

Product

Resources

About