[The role of laparoscopy in cholecystectomy in patients 80 years old and older]

Abstract

Introduction: The incidence of cholelithiasis increases with age, however, there is still little data about the outcomes of cholecystectomy in patients with age of 80 and above. Population ageing presents tremendous challenges for surgeons.

Aim: The aim of the authors was to compare emergency and elective cholecystectomies performed in these elderly patients.

Method: This retrospective study was based on the analysis of operation type, conversion rate, complications, mortality, length of hospital stay of all patients over 80 who underwent cholecystectomy in the last 6 years at the 1st Department of Surgery, Semmelweis University.

Results: 69 elective and 51 emergency operations were performed. In the emergency group pancreatitis was found in 9.8%, liver abscess in 14%, and common bile duct stones in 27% of the patients on admission. Laparoscopic cholecystectomy could be performed in 84% of patients in the elective group, while in 17.7% of patients in the emergency group. The length of stay at the intensive care unit was 9.1 and 1 days, while the total length of hospital stay was 12 and 3.6 days for the elective and emergency groups, respectively. In the emergency group mortality was 20% and reoperation was performed in 16% of patients, while at the elective group none of these occurred.

Conclusion: Laparoscopic cholecystectomy is safe as elective surgery for patients with age of 80 and above. For this reason the authors recommend elective cholecystectomy in this age group.

Keywords: cholecystectomia; cholecystectomy; extreme elderly; idős; laparoscopy; laparoszkópia; morbidity; morbiditás; mortality; mortalitás.