Laparoscopic cholecystectomy in the elderly

Zappulla, E; Russo, Vittorio; Gullotta, I; Patanè, Giovanni; Trovato, Salvatore C.; Lucifora, B; Costa, S; Tracia, Angelo; Caglià, Pietro; Amodeo, C

doi:10.1186/1471-2318-9-s1-a11

Cited by 2 publications

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“…In the study by Story et al, 20% of patients developed at least one complication within 5 days following surgery, and 5% died within 30 days after surgery (32). The study by Fukuse et al examining patients older than 60 years reported that postoperative complications occurred in 16.7% of patients (16), while the study by Zappulla et al analyzing patients aged more than 70 years indicated even a lower complication rate (10%) (5). The above data show that complication rates vary across different studies depending on different pathologies and complications analyzed.…”

Section: Discussionmentioning

confidence: 98%

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Perioperative Factors Affecting Length of Hospital Stay Among Elderly Patients

et al. 2013

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Background and Objective. Timely assessment and prevention of risk factors for the main perioperative complications in elderly patients provide an opportunity to avoid them, decrease mortality, and diminish costs associated with longer hospital stay. The aim of this study was to estimate perioperative factors that could potentially predict the length of stay and to estimate their predictive value using a comprehensive geriatric assessment among elderly patients. Material and Methods. The study population comprised 99 surgical patients aged 65 and more. The patients were followed up until discharge. Study data analysis included questionnaires, anthropometric measurements before surgery, assessment and interviews after surgery, and case histories. Univariate and multivariate logistic regression analysis was performed. Results. Malnutrition was detected in 53.5% of the patients. Postoperative cognitive disorder was documented in 18.2% of elderly patients. The mean length of hospital stay was 10.1 days (SD, 9.14). Multivariate logistic regression analysis revealed that the best predictors for longer hospital stay in elderly patients were malnutrition (OR, 4.2; 95% CI, 1.5–11.8; P=0.007) together with postoperative cognitive impairment (OR, 9.2; 95% CI, 1.0–83.3; P=0.048). The total predictive value of the model was 70.5%. Conclusions. Malnutrition and a postoperative cognitive disorder were independent risk factors for longer hospital stay, while depression, cognitive impairment, functional dependence, and poor physical status were not independently associated with longer hospital stay. A comprehensive geriatric assessment can help assess the risk factors for longer treatment and predict the length of hospital stay, thus enabling the planning of optimal healthcare management of elderly patients.

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Section: Discussionmentioning

confidence: 98%

“…In older age, a decline in functional reserve, impaired reaction to stress, and comorbidities lead to increased postoperative complication and rehospitalization rates, longer duration of postoperative treatment, and higher costs of treatment (1)(2)(3)(4)(5)(6).…”

Section: Introductionmentioning

confidence: 99%

Perioperative Factors Affecting Length of Hospital Stay Among Elderly Patients

et al. 2013

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Perioperative outcomes after laparoscopic cholecystectomy in elderly patients: a systematic review and meta-analysis

et al. 2020

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Background Laparoscopic cholecystectomy is increasingly performed in an ever ageing population; however, the risks are poorly quantified. The study aims to review the current evidence to quantify further the postoperative risk of cholecystectomy in the elderly population compared to younger patients. Method A systematic literature search of PubMed, EMBASE and the Cochrane Library databases were conducted including studies reporting laparoscopic cholecystectomy in the elderly population. A meta-analysis was reported in accordance with the recommendations of the Cochrane Library and PRISMA guidelines. Primary outcome was overall complications and secondary outcomes were conversion to open surgery, bile leaks, postoperative mortality and length of stay. Results This review identified 99 studies incorporating 326,517 patients. Increasing age was significantly associated with increased rates of overall complications (OR 2.37, CI95% 2.00–2.78), major complication (OR 1.79, CI95% 1.45–2.20), risk of conversion to open cholecystectomy (OR 2.17, CI95% 1.84–2.55), risk of bile leaks (OR 1.50, CI95% 1.07–2.10), risk of postoperative mortality (OR 7.20, CI95% 4.41–11.73) and was significantly associated with increased length of stay (MD 2.21 days, CI95% 1.24–3.18). Conclusion Postoperative outcomes such as overall and major complications appear to be significantly higher in all age cut-offs in this meta-analysis. This study demonstrated there is a sevenfold increase in perioperative mortality which increases by tenfold in patients > 80 years old. This study appears to confirm preconceived suspicions of higher risks in elderly patients undergoing cholecystectomy and may aid treatment planning and informed consent.

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Laparoscopic cholecystectomy in the elderly

Cited by 2 publications

References 0 publications

Perioperative Factors Affecting Length of Hospital Stay Among Elderly Patients

Perioperative Factors Affecting Length of Hospital Stay Among Elderly Patients

Perioperative outcomes after laparoscopic cholecystectomy in elderly patients: a systematic review and meta-analysis

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