Colecistectomía laparoscópica en pacientes mayores de 80 años

Ladra, María Jesús; Paredes, Jesús P.; Flores, Enrique; Martínez, Lucía Lesquereux; Rojo, Yago; Potel, J; Beiras, Alejandro

doi:10.1016/s0009-739x(09)70083-1

Cited by 1 publication

(4 citation statements)

References 16 publications

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“…We found no significant differences in clinical characteristics and outcomes between the two age groups. The results, in terms of morbidity and mortality, were comparable to other published reports on cholecystectomy in octogenarians, even though some of those reports included nonacute conditions or did not include Grade III AC [11–13].…”

Section: Discussionsupporting

confidence: 81%

“…Laparoscopic cholecystectomy in older patients was shown to be a safe treatment option even in case of AC [7, 11–13, 15–17], although conservative treatment can also be justified [7, 19]. The latter can initially give good results, but in our study 11 patients out of 240 on conservative treatment had to be urgently operated because of the rapid deterioration.…”

Section: Discussionmentioning

confidence: 81%

“…We consider that laparoscopic cholecystectomy can be safely performed in many patients of up to 85 years, as previously demonstrated [11–14]. However, the optimal management of AC in patients >85 years is less clear.…”

Section: Introductionmentioning

confidence: 77%

“…Some authors propose to adapt watchful waiting in patients with symptomatic cholelithiasis who are older than 90 years and to recur to cholecystectomy only when the condition evolves into AC [17]. Laparoscopic cholecystectomy was shown to be safe in patients older than 80 years [11, 13, 17] and helps to avoid readmissions and complications related to biliary tract problems. The optimal moment for cholecystectomy is not well defined.…”

Section: Discussionmentioning

confidence: 99%

See 3 more Smart Citations

Acute Cholecystitis in Very Elderly Patients: Disease Management, Outcomes, and Risk Factors for Complications

Escartín

González

Cuello

et al. 2019

Surgery Research and Practice

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Background. The aim of this study was to evaluate the characteristics, management, and outcomes of acute cholecystitis in patients ≥80 years. Methods. This was a retrospective analysis of data from a prospective single-center patient registry. Results. The study population was composed of 348 patients, which were divided into two groups: those younger (Group A) and those older (Group B) than the median age (85.4 years). Although demographic and clinical characteristics of the two groups were similar, the disease management was clearly different, with older patients undergoing cholecystectomy less frequently (n=80 46.0% in Group A vs n=39 22.4% in Group B; p<0.001). The outcomes in both groups of age were similar, with 30-day mortality of 3.7%, morbidity of 17.2%, and readmissions of 4.2% and two-year AC recurrence in nonoperated patients of 22.5%. No differences were seen between operated and no operated patients. Severe (Grade III) AC was the only independent factor significantly associated with mortality (OR 86.05 (95% CI: 11–679); p<0.001). Conclusions. In elderly patients with AC, the choice of therapeutic options was not limited by the age per se, but rather by the disease severity (grade III AC) and/or poor physical status (ASA III-IV). In case of grade I-II AC, laparoscopic cholecystectomy can be safely performed and yield good results even in very old patients. Patients with grade III AC present high risk of morbidity and mortality, and the treatment should be individualized. ASA IV patients should avoid cholecystectomy, being antibiotic treatment and cholecystectomy the best option.

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Section: Discussionsupporting

confidence: 81%