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KMID : 0371320090760040231
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Journal of the Korean Surgical Society
2009 Volume.76 No. 4 p.231 ~ p.235
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Is Laparoscopic Cholecystectomy Safe in Octogenarians?
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Cho Ja-Yun
Kim Sang-Geol
Yeun Young-Guk
Hwang Yoon-Jin
Chang Su-Kurn
Kim Jong-Yeol
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Abstract
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Purpose: Biliary tract disease is one of the most common causes of acute abdominal pain in elderly patients, but there is still some debate over treatment. The aim of this study is to determine the safety and surgical outcomes of laparoscopic cholecystectomy (LC) for benign gallbladder disease in octogenarian patients.
Methods: We selected 42 patients of 80 years or older who underwent LC or open-converted cholecystectomy (OC) from February 1992 to November 2006. We evaluated clinicopathological features, treatment modalities, and surgical outcomes retrospectively.
Results: The patients included 17 males and 25 females. The mean age of the patients was 83.3 and 83.7, respectively. Right upper quadrant pain was the most common symptom, present in 85.7% of the patients. Gallstones were present in 85.7%. ASA class II and III comprised 92.9% of the patients. Comorbidities included hypertension, cardiac disease, pulmonary disease, and diabetes mellitus. Preoperatively biliary drainage was performed in 12 cases (endoscopic drainage in 8, percutaneous drainage in 4 cases). Preoperative cholecystostomy was performed in 5 cases. Emergency operations were more frequent than elective surgery (25 vs. 17). Mean hospital stay of LC patients was 5 days, whereas that of OC patients was 13 days. Open conversion rate was 16.7%. No surgical mortality was present and postoperative morbidity included acute myocardial infarction in one patient and wound infection in one patient.
Conclusion: LC in octogenarian patients was safe. However, since the incidence of comorbidities is high in these patients, great care should be taken to evaluate and manage the comorbidities before surgery.
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KEYWORD
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Laparoscopic cholecystectomy, Octogenarian
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