To assess the impact of disease entity on mortality and morbidity in geriatric patient group with biliary lithiasis. To compare mortality, morbidity in GB stone group with those in CBD, IHD stone group among old ages. Furthermore to help in
making
a
basis for operative treatment. We reviewed our experience with 388 patients older than 60 years who underwent surgery for biliary lithiasis from January 1, 1991 to December 31, 1993 in our department.
1) In the GB stone group there were 110 males and 178 females, with a sex ratio of 1:1.6. In the CBD and IHD stone group there were 42 males and 58 females with a sex ratio of 1 : 1.4.
2) In order of frequency symptoms and signs were RUQ pain(72%), indigestion(16%), nausea and vomiting(7%), fever and chill(1%), jaundice(0.7%), in the GB stone group; fever and chil(13%), indigestion(10%), jaundice(10%), nausea and vomiting(7%)
in
the
CBD and IHD stone group.
3) In the laboratory data, increased WBC count was found in 46 cases(16%), increased alkaline phosphatase in 43 cases(15%), increased bilirubin in 20 cases(7%) in the GB stone group, 38 cases(38%), 75 cases(75%), 44 cases(44%) in the CBD and IHD
stone
group.
4) The duration of symptoms was less than 10 years in 113 cases(39.2%), 1 month 82 cases (28.5%), 1 year 50 cases(17.3%), 1 week 27 cases(9.4%), more than 10 years 16 cases(5.6%) in the GB stone group; less than 1 month 43 cases(43%), 1 week 23
cases(23%), 10 years 18 cases(18%), 1 year 13 cases(13%), more than 10 years 3 cases(3%) in the CBD and IHD stone group.
5) The preoperative risk factors were hypertension 73 cases(25%), diabetes mellitus 20 cases (7%), peptic ulcer 16 cases(5%) in the GB stone group, hypertesion 26 cases(26%), diabetes mellitus 16 cases(16%), cholangitis 10 cases(10%) in the CBD
and IHD
stone group.
6) The most common preoperative hospitalization was less than 3 days 169 cases(58.7%) in the GB stone group, less than 7 days 56 cases(56%) in the CBD and IHD stone group. the most common postoperative hospitalization was less than 14 days 131
cases(45.5%), 42 cases(42%) in the GB stone group and CBD & IHD stone group.
7) The operative methods were cholecystectomy 158 cases(54.9%), laparoscopic cholecystectomy 123 cases(42.7%), cholecystectomy & CBD exploration 7 cases(2.4%) in the GB stone group, cholecystectomy & CBD exploration 75 cases(75%), T-tube
choledochostomy 75 cases(75%), choledochojejunostomy 2 cases(2%) in the CBD & IHD stone group.
8) The most common complications were wound infection 21 cases(7.3%), pulmonary complications 20 cases(6.9%), bile leakage 9 cases(3%) in the GB stone group, pulmonary complications 14 cases(14%), bile leakage 10 cases(10%) in the CBD and IHD
stone
group. Besides, residual stones presented in 32 cases(32%).
9) In the GB stone group, 1 case died of acute renal failure, 3 cases in the BD and IHD stone group by acute renal failure and multiple organ failure.
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