The impact of dementia on surgical outcomes of laparoscopic cholecystectomy for symptomatic cholelithiasis and acute cholecystitis: A retrospective study

Abstract

IntroductionThe aim of this study was to clarify the impact of dementia on surgical outcomes of laparoscopic cholecystectomy for symptomatic cholelithiasis and acute cholecystitis.MethodsWe reviewed medical data of 96 patients who underwent laparoscopic cholecystectomy for symptomatic cholecystitis and acute cholecystitis. The patients were divided into the dementia group (n = 18) and non‐dementia group (n = 78). Clinical features of the patients and surgical outcomes were compared between the two groups.ResultsMean age and rates of The American Society of Anesthesiologists Physical Status classification score > 2 in the dementia group were significantly higher than those of the non‐dementia group (P < .001, P = .008, respectively). Incidences of acute cholecystitis and the rate of percutaneous transhepatic gallbladder drainage in the dementia group were significantly higher than those of the non‐dementia group (P = .009, P = .01, respectively). The rates of conversion to laparotomy and non‐surgical complications in the dementia group were higher than those in the non‐dementia group (P = .02, P = .03, respectively). Postoperative hospital stay in the dementia group was significantly longer than that in the non‐dementia group (15.2 ± 9.3 vs 8.2 ± 3.2 days, P = .009). Subgroup analysis of patients with acute cholecystitis showed postoperative hospital stay in the dementia group to be significantly longer than that in the non‐dementia group (18.7 ± 10.7 vs 10.3 ± 4.2 days, P = .03).ConclusionPatients with dementia who underwent laparoscopic cholecystectomy have a high incidence of acute cholecystitis and a high rate of percutaneous transhepatic gallbladder drainage, which may result in increased rates of conversion to laparotomy and prolong the postoperative hospital stay.

Preoperative nursing visit reduces preoperative anxiety and postoperative complications in patients with laparoscopic cholecystectomy

“…Laparoscopic cholecystectomy (LC) was conducted for the first time in 1987, [ 1 ] and it is now a successful surgical method to treat the biliary colic, cholecystitis, and cholelithiasis. [ 2 – 4 ] The popularization rate of LC is getting higher and higher, which is mainly because the surgical scars left by laparoscopic surgeries is very small; it only needs a short hospital stay, and can promote the early recovery. Compared with the traditional open surgeries, LC improves the outcome and is regarded as the standard-of-care of the cholecystitis treatment.…”

Dementia is Associated With Inferior Outcomes Following Emergency General Surgery

“…[5][6][7][8] For instance, Ninomiya and colleagues analyzed patients undergoing laparoscopic cholecystectomy and found no differences in mortality based on dementia status. 15 Bekelis et al reported on nearly 350,000 patients undergoing a broad range of cardiac, neurosurgical, and vascular operations and similarly found no association between dementia and mortality. 4 In contrast, the present study found dementia to be associated with increased odds of in-hospital mortality following all included emergency general surgery procedures except repair of perforated ulcer.…”