Outcomes analysis of laparoscopic cholecystectomy in the extremely elderly

Abstract

Laparoscopic cholecystectomy in the extremely elderly is associated with more complications and a higher rate of conversion to open cholecystectomy than in elderly individuals younger than 80 years. The greater chance of encountering a severely inflamed or scarred gallbladder and common bile duct stones as well as increasing comorbidities likely account for these differences in outcome.

Colecistectomia videolaparoscópica em 960 pacientes idosos

“…9,15,19,25,26 In this work, the causes were represented by three major conditions: sepsis, mesenteric infarction and myocardial infarction. The latter was also observed by Brunt et al 21 and more recently by Malik et al 10 . Other causes of death have been described 25 .…”

“…This morbidity was lower than that reported by several authors 12,[19][20][21] . The vast majority of perioperative and postoperative complications had little or no impact on the final results.…”

Laparoscopic Cholecystectomy Conversion Rates Two Decades Later

“…Another patient-specific risk factor for conversion was advanced age. 5–8,26 In the current study, the CR in the older patient group (>50 years old) was nearly 6-fold higher than in younger patients. Previous findings have found 2- to 4-fold higher CRs in older patients.…”

“…5–7,27 Notably, elderly patients have a higher incidence of severe, acute, and gangrenous cholecystitis as well as an increased incidence of comorbid cardiopulmonary disease, choledocholithiasis, and prior abdominal surgery, which may contribute to the higher CR. 7,26,27 Finally, prior abdominal surgery has also been associated with a higher likelihood of conversion in numerous studies. 7,8,28 Prior surgery, especially in the upper abdomen, may result in adhesions around the gallbladder, limiting visualization, retraction, and dissection.…”

Resultados de la colecistectomía videolaparoscópica en el adulto mayor

“…Por otro lado, la colecistolitiasis en Chile es una patología quirúrgica de muy alta incidencia, afectando también a la población de ambos sexos, en edades iguales o mayores de 60 años [4][5][6] . Todo lo anterior, explica que la colecistectomía videolaparoscópica en el paciente adulto mayor sea frecuente hoy en día [8][9][10] . De particular interés es el hecho que en este grupo etario se incluye pacientes de mayor riesgo anestésico…”