Laparoscopic cholecystectomy in super elderly (&gt; 90 years of age): safety and outcomes

Ramírez-Giraldo, Camilo; Rosas-Morales, Camila; Vásquez, Fiamma; Isaza‐Restrepo, Andres; Ibáñez-Pinilla, Milcíades; Vargas-Rubiano, Saul; Vargas-Barato, Felipe

doi:10.1007/s00464-023-10048-3

Cited by 4 publications

(1 citation statement)

References 31 publications

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“…For the stratification of the variable "Age", we used the reported variables by a study by Ramírez et al 15 Appearance of severe complications (Clavien-Dindo score III/V) percentages were calculated as 82% (28/34) for the group ≥60 years and 18% (6/34) for the group <60 years.…”

Section: Sample Group Assignationmentioning

confidence: 99%

Timing of CHolecystectomy In Severe PAncreatitis (CHISPA): study protocol for a randomized controlled trial

Ramírez-Giraldo,

Conde Monroy,

Daza Vergara

et al. 2024

BMJ Surg Interv Health Technologies

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Acute pancreatitis is the recurrent reason for gastrointestinal admission in a clinical urgent setting, it happens secondary to a wide array of pathologies out of which biliary disease stands as one of the most frequent causes for its presentation. Approximately 20% of pancreatitis are of moderate or severe severity. Currently, there is not a clear recommendation on timing for cholecystectomy, either early or delayed.CHISPA is a randomized controlled, parallel-group, superior clinical trial. An intention-to-treat analysis will be performed. It seeks to evaluate differences between patients taken to early cholecystectomy during hospital admission (72 hours after randomization) versus delayed cholecystectomy (30±5 days after randomization). The primary endpoint is major complications associated with laparoscopic cholecystectomy defined as a Clavien-Dindo score of over III/V during the first 90 days after the procedure. Secondary endpoints include recurrence of biliary disease, minor complications (Clavien-Dindo score below III/V), days of postoperative hospital stay, and length of stay in an intensive therapy unit postoperatively (if it applies).The CHISPA trial has been designed to demonstrate that delayed laparoscopic cholecystectomy reduces the rate of complications associated to an episode of severe biliary pancreatitis compared to early laparoscopic cholecystectomy.Trial registration number:NCT06113419.

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Section: Sample Group Assignationmentioning

confidence: 99%

Timing of CHolecystectomy In Severe PAncreatitis (CHISPA): study protocol for a randomized controlled trial

Ramírez-Giraldo,

Conde Monroy,

Daza Vergara

et al. 2024

BMJ Surg Interv Health Technologies

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Outcomes after laparoscopic cholecystectomy in patients older than 80 years: two-years follow-up

Ramírez-Giraldo,

Venegas-Sanabria,

Rojas-López

et al. 2024

BMC Surg

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Background The laparoscopic cholecystectomy is the treatment of choice for patients with benign biliary disease. It is necessary to evaluate survival after laparoscopic cholecystectomy in patients over 80 years old to determine whether the long-term mortality rate is higher than the reported recurrence rate. If so, this age group could benefit from a more conservative approach, such as antibiotic treatment or cholecystostomy. Therefore, the aim of this study was to evaluate the factors associated with 2 years survival after laparoscopic cholecystectomy in patients over 80 years old. Methods We conducted a retrospective observational cohort study. We included all patients over 80 years old who underwent laparoscopic cholecystectomy. Survival analysis was conducted using the Kaplan‒Meier method. Cox regression analysis was implemented to determine potential factors associated with mortality at 24 months. Results A total of 144 patients were included in the study, of whom 37 (25.69%) died at the two-year follow-up. Survival curves were compared for different ASA groups, showing a higher proportion of survivors at two years among patients classified as ASA 1–2 at 87.50% compared to ASA 3–4 at 63.75% (p = 0.001). An ASA score of 3–4 was identified as a statistically significant factor associated with mortality, indicating a higher risk (HR: 2.71, CI95%:1.20–6.14). Conclusions ASA 3–4 patients may benefit from conservative management due to their higher risk of mortality at 2 years and a lower probability of disease recurrence.

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Comparison of Safety and Efficacy between Laparoscopic Ventral Rectopexy and Delorme's Procedure for External Rectal Prolapse in Nonagenarians

Tsunoda,

Matsuda,

Kusanagi

2024

J Anus Rectum Colon

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Objectives: This study evaluates the safety and efficacy of laparoscopic ventral rectopexy (LVR) in nonagenarian patients with external rectal prolapse (ERP) compared to Delorme's procedure. Methods: We conducted a retrospective analysis of prospectively collected data, including nonagenarian patients who underwent either LVR or Delorme's procedure, comparing outcomes such as morbidity, length of hospital stay (LOS), and recurrence rates. Results: Between September 2009 and August 2023, 22 patients (median age 91, range 90−94 years) underwent LVR, while 12 patients (median age 91, range 90−96 years) received Delorme's procedure. Baseline characteristics, including sex ratio, parity, American Society of Anesthesiology grade, and Body Mass Index, did not significantly differ between the groups. LVR had a significantly longer operating time but lower blood loss than Delorme's procedure. Postoperative LOS was significantly shorter for LVR patients (median 1, range 1−3 days) compared to Delorme's procedure patients (median 2.5, range 1−13 days; P = 0.001). Notably, no significant morbidity occurred in the LVR group, while one case of delirium and another of solitary rectal ulcer syndrome were observed in the Delorme's procedure group. Recurrence rates were lower in the LVR group, with no recurrences during a median follow-up of 23 months (range 1−65 months), compared to one recurrence at 2 months during a median follow-up of 34 months (range 1−96 months) in the Delorme's procedure group. Conclusions: LVR is a safe and effective surgical option for nonagenarian ERP patients, showing favorable outcomes in terms of morbidity, LOS, and recurrence rates compared to Delorme's procedure.

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Laparoscopic cholecystectomy in super elderly (> 90 years of age): safety and outcomes

Cited by 4 publications

References 31 publications

Timing of CHolecystectomy In Severe PAncreatitis (CHISPA): study protocol for a randomized controlled trial

Timing of CHolecystectomy In Severe PAncreatitis (CHISPA): study protocol for a randomized controlled trial

Outcomes after laparoscopic cholecystectomy in patients older than 80 years: two-years follow-up

Comparison of Safety and Efficacy between Laparoscopic Ventral Rectopexy and Delorme's Procedure for External Rectal Prolapse in Nonagenarians

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