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. 2020 Jul;13(3):351-358.
doi: 10.1111/ases.12743. Epub 2019 Aug 7.

The impact of dementia on surgical outcomes of laparoscopic cholecystectomy for symptomatic cholelithiasis and acute cholecystitis: A retrospective study

Shigeo Ninomiya  1   2 , Shota Amano  1 , Tadashi Ogawa  1 , Yoshitake Ueda  3 , Norio Shiraishi  3 , Masafumi Inomata  2 , Katsuhiro Shimoda  1
Affiliations

The impact of dementia on surgical outcomes of laparoscopic cholecystectomy for symptomatic cholelithiasis and acute cholecystitis: A retrospective study

Shigeo Ninomiya et al. Asian J Endosc Surg. 2020 Jul.

Abstract

Introduction: The aim of this study was to clarify the impact of dementia on surgical outcomes of laparoscopic cholecystectomy for symptomatic cholelithiasis and acute cholecystitis.

Methods: We reviewed medical data of 96 patients who underwent laparoscopic cholecystectomy for symptomatic cholecystitis and acute cholecystitis. The patients were divided into the dementia group (n = 18) and non-dementia group (n = 78). Clinical features of the patients and surgical outcomes were compared between the two groups.

Results: Mean age and rates of The American Society of Anesthesiologists Physical Status classification score > 2 in the dementia group were significantly higher than those of the non-dementia group (P < .001, P = .008, respectively). Incidences of acute cholecystitis and the rate of percutaneous transhepatic gallbladder drainage in the dementia group were significantly higher than those of the non-dementia group (P = .009, P = .01, respectively). The rates of conversion to laparotomy and non-surgical complications in the dementia group were higher than those in the non-dementia group (P = .02, P = .03, respectively). Postoperative hospital stay in the dementia group was significantly longer than that in the non-dementia group (15.2 ± 9.3 vs 8.2 ± 3.2 days, P = .009). Subgroup analysis of patients with acute cholecystitis showed postoperative hospital stay in the dementia group to be significantly longer than that in the non-dementia group (18.7 ± 10.7 vs 10.3 ± 4.2 days, P = .03).

Conclusion: Patients with dementia who underwent laparoscopic cholecystectomy have a high incidence of acute cholecystitis and a high rate of percutaneous transhepatic gallbladder drainage, which may result in increased rates of conversion to laparotomy and prolong the postoperative hospital stay.

Keywords: acute cholecystitis; dementia; laparoscopic cholecystectomy.

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