Outcome Analysis of Laparoscopic Cholecystectomy in Patients Aged 80 Years and Older with Complicated Gallstone Disease

Abstract

The LC can be performed with acceptable morbidity in octogenarians with complicated gallstone disease. Early treatment of gallstone disease in this age group could further improve outcomes.

Percutaneous drainage for acute calculous cholecystitis

“…These results are concurrent with our findings of 14.8% overall mortality and 3.7% procedure-related mortality. In the current literature, complication rates for elective LC in elderly or otherwise high-risk surgical patients vary from 5 to 17% [2,3,7,8] and mortality rates vary from 0 to 1.7% [7,13]. When LC is performed for acute cholecystitis in this population, rates are higher, with complication rates up to 41% [2-5, 7, 8, 14] and mortality rates up to 4.5% [4][5][6].…”

Outcome Analysis of Patients with Gallstone Disease Receiving Cholecystectomy: A Population-Based Cohort Study

“…In addition to T2DM, some other underlying risk factors or comorbidities that may affect the life expectancy for GSD patients who underwent cholecystectomy should be taken into consideration in the future. Because patients who underwent cholecystectomy may reflect a more severe or complicated GSD, including larger gallstones, porcelain gallbladder, gallbladder polyps, and immunosuppression [48]. Porcelain gallbladder has received considerable attention due to its perceived association with the risk of gallbladder carcinoma [49].…”

Laparoscopic cholecystectomy: consensus conference-based guidelines

“…The treatment and surveillance of GPL are still controversial as a result of the lack of RCTs [75]. There is no evidence from trials to recommend surgery or not for patients with GPL smaller than 10 mm [76] (LE1).…”

“…The primary goal in GPL management is to prevent gallbladder carcinoma [78] with an appropriate balance between the risk of malignancy (ranging between 45 and 67 % in polyps between 10 and 15 mm in size [79][80][81][82]), and the risks associated to LC (LE4). The evidence of multiple polyps per se is not an indication for surgery [75] (LE4). In patients with age ≥60, sessile polyp morphology, and polyp size ≥10 mm, EUS or CT for accurate characterization is advised [78] (LE4).…”