Laparoscopic Cholecystectomy in Elderly Patients

Yetkın, Gürkan; Uludağ, Mehmet; Oba, Sibel; Çıtgez, Bülent; Paksoy, İnci

doi:10.4293/108680809x1258998404604

Cited by 54 publications

(64 citation statements)

References 22 publications

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“…This was comparable with other studies, like 2% as observed by Bhasin et al, 3.2% by Mulhim et al, and 0% by Duca et al [20,21,28] We found contracted or shrunken gall bladder in 4% cases, as compared to 15.07% found by Lal et al [29] Conversion to Open Cholecystectomy was required in 8%. This was comparable to the conversion rate of 12% as observed by Shah et al, 4% by Bhasin et al, and 8% by Yetkin et al [19,20,27] …”

Section: Disscusionsupporting

confidence: 89%

“…[19,21,27] Difficult Calot's triangle was observed in 22 cases. In comparison, difficult Calot's triangle was found by Shah et al in 12% cases, Yetkin et al in 5.3%, and Duca et al in 9.8%.19, [27,28] In our study, calculus impacted at the neck of gall bladder or Hartmann's pouch was found in 10%. This was similar to the findings observed by Lal et al (11 out of 73 cases; 15.07%).…”

Section: Disscusionmentioning

confidence: 99%

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A Prospective Study of 100 Consecutive Laparoscopic Cholecystectomies

Huda¹,

Kumar²,

Singh³

2017

AIMDR

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Background: Cholelithiasis, the leading cause for hospital admissions related to gastrointestinal problems, had been traditionally dealt by open cholecystectomy. Erich Muhe performed the first laparoscopic cholecystectomy on September 12, 1985. In September 1992, a National Institute of Health (NIH) consensus conference held in Bethesda concluded that laparoscopic cholecystectomy should be the treatment of choice for gallstone disease. This study on laparoscopic cholecystectomy was done to illustrate the clinical manifestations and peroperative findings in gallstone disease. Methods: We prospectively studied 100 consecutive cases undergoing laparoscopic cholecystectomy at our institute. Presenting complaints, laboratory investigations and USG findings were noted. Standard 4-port laparoscopic cholecystectomy was performed, with closed method using Veress needle preferred for the first (umbilical) port. All peroperative findings were analyzed. Results: Majority of the patients were female (79%), and the average age of the patients was 40.18 years. Pain in upper abdomen was the most common presenting complaint (93%) and an association with meal was found in 85%. Peroperatively, multiple calculi were found in 77%, with impaction of calculus at neck seen in 10% of the patients. Distended gall bladder was seen in 19%, and mucocele in 3%. Shrunken gall bladder was observed in 4%. Difficult Calot's triangle, due to adhesions, was found in 22%. Biliary tree or vascular anomaly was seen in 8%. Mean postoperative hospital stay was 1.92 days. Conclusion: Pain abdomen in gallstone disease is commonly seen in association with meals. Thick-walled gall bladder, adhesions at Calot's triangle, and distended gall bladder are common peroperative findings.

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Section: Disscusionsupporting

confidence: 89%

Section: Disscusionmentioning

confidence: 99%

A Prospective Study of 100 Consecutive Laparoscopic Cholecystectomies

Huda¹,

Kumar²,

Singh³

2017

AIMDR

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“…Studies suggested that LC was safe, did not increase complication rates, shortened the time of hospitalization, and was associated with a marked improvement in the quality of life for the elderly. Surgeons were recommended to complete an operation in the laparoscopic setting as much as possible in patients with advanced age (12,(21)(22)(23)(24)(25). In our study, the mean age did not significantly differ between the two groups.…”

mentioning

confidence: 48%

Laparoscopic partial cholecystectomy: A safe and effective alternative surgical technique in "difficult cholecystectomies"

Kulen¹,

Tıhan²,

Duman³

et al. 2016

UCD

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Objective: Laparoscopic cholecystectomy has become the ''gold standard'' for benign gallbladder diseases due to its advantages. In the presence of inflammation or fibrosis, the risk of bleeding and bile duct injury is increased during dissection. Laparoscopic partial cholecystectomy (LPC) is a feasible and safe method to prevent bile duct injuries and decrease the conversion (to open cholecystectomy) rates in difficult cholecystectomies where anatomical structures could not be demonstrated clearly. Material and Methods:The feasibility, efficiency, and safety of LPC were investigated. The data of 80 patients with cholelithiasis who underwent LPC (n=40) and conversion cholecystectomy (CC) (n=40) were retrospectively examined. Demographic characteristics, ASA scores, operating time, drain usage, requirement for intensive care, postoperative length of hospital stay, surgical site infection, antibiotic requirement and complication rates were compared. Results:The median ASA value was 1 in the CC group and 2 in the LPC group. Mean operation time was 123 minutes in the CC group, and 87.50 minutes in the LPC group. Surgical drains were used in 16 CC patients and 4 LPC patients. There was no significant difference between groups in postoperative length of intensive care unit stay (p=0.241). When surgical site infections were compared, the difference was at the limit of statistical significance (p=0.055). Early complication rates were not different (p=0.608) but none of the patients in the LPC group suffered from late complications. Conclusion:LPC is an efficient and safe way to decrease the conversion rate. LPC seems to be an alternative procedure to CC with advantages of shorter operating time, lower rates of surgical site infection, shorter postoperative hospitalization and fewer complications in high-risk patients.

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“…During this study we had encountered multiple factors that resulted in conversion of laparoscopic cholecystectomy to open cholecystectomy with adhesion in calot's triangle dominated the intraoperative findings, followed by bleeding and acute inflammatory changes around gall bladder and intolerance to pneumoperitoneum [16,21,23].…”

Section: Discussionmentioning

confidence: 99%

Conversion of Laparoscopic Cholecystectomy to Open Cholecystectomy: An Analysis in a High Risk Group of Patients

Mir¹,

Bhat²,

Khan³

et al. 2017

J Univer Surg

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Background: Laparoscopic cholecystectomy (LC) has revolutionized minimally invasive surgery, considered as gold standard and increasing number of procedures are done for patients with various high risk comorbid conditions. LC today can be as straightforward operation, but may also be an operative approach fraught with underlying complexities necessitating conversion to open cholecystectomy leading to longer operative time, longer hospital stay and more postoperative morbidity and higher hospital costs. We have tried to estimate the rate and risk factors which are associated with the conversion.

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Laparoscopic Cholecystectomy in Elderly Patients

Abstract: Laparoscopic surgery can be safely applied in the elderly. Complications can be minimized by carefully selecting patients aged 80 years or older and operating on these patients with experienced teams with good technical capabilities.

Cited by 54 publications

References 22 publications

A Prospective Study of 100 Consecutive Laparoscopic Cholecystectomies

A Prospective Study of 100 Consecutive Laparoscopic Cholecystectomies

Laparoscopic partial cholecystectomy: A safe and effective alternative surgical technique in "difficult cholecystectomies"

Conversion of Laparoscopic Cholecystectomy to Open Cholecystectomy: An Analysis in a High Risk Group of Patients

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