Is Laparoscopic Cholecystectomy a Safe Method For Elderly Patients? A Retrospective Clinical Study

As in developed countries, the elderly population is gradually growing in our country. Therefore, the approach to diseases of these individuals may be different from adults and young individuals. Acute cholecystitis is common in elderly patients and may sometimes pose a high risk. In this clinical study, we aimed to compare our surgical treatment outcomes for acute cholecystitis in elderly and adult patients. The study included 225 patients who were operated with the diagnosis of acute cholecystitis in the General Surgery Clinic of Seyhan State Hospital between 2013 and 2019. The patients were divided into 2 groups according to their ages. The group 1 consisted of patients aged 75 years and older, while the group 2 included patients younger than 75 years of age. The patient data were obtained by scanning the database. The preoperative and postoperative data of the patients were recorded. The patients' age, morbidity, mortality and duration of hospital stay were compared. When the patients in the elderly ages were investigated with the subjects in the adult group, there was no statistically meaningful difference between the subjects in terms of conversion from laparoscopic to open surgery, bleeding, bile leak, abscess and peritoneal collection. Our mortality and morbidity rates were not differ in both groups and were consistent with the literature. Elderly patients with acute cholecystitis can be managed laparoscopically, as in other adult patients. Treatment approaches do not vary for elderly and young patients.

___

1. Kuy S, Sosa J.A, Roman S.A, Desai R., Rosenthal RA, Age matters: a study of clinical and economic outcomes following cholecystectomy in elderly Americans. Am J. Surg 2011; 201: 789-7986.

2. Maekawa S, Nomura R, Murase T, Ann Y, Oeholm M, Harada M. Endoscopic gallbladder stenting for acute cholecystitis: a retrospective study of 46 elderly patients aged 65 years or older. BMC Gastrol 2013; 13: 65.

3. Indar AA, Beckingham IJ. Acute cholecystitis. BMJ 2002; 325: 639-643.

4. Hirota M, Takada T, Kawara Y, et al. Diagnostic criteria and severity assessment of acute cholecystitis: Tokyo Guidelines. J Hepatobiliary Pancreat Surg 2007; 14: 78-82.

5. Frazee RC, Nagorney DM, Mucha P Jr. Acute acalculous cholecystitis. Mayo Clin Proc 1989; 64: 163-167.

6. Patterson EJ, Mcloughlin RF, Mathieson JR, Cooperberg PL, Macfarlane JK. An alternative approach to acute cholecystostomy and interval laparoscopic cholecystectomy. Surg Endosc 1996; 10: 1185-1188.

7. Gunay Y, Emek E, Bircan HY, Aktas S, Demirag A. Yaşlılarda akut kolesistit tedavisine yaklaşım: perkütan kolesistostomi veya kolesistektomi. Fırat Tıp Dergisi 2013; 18: 239-243.

8. Cheng WC, Chiu YC, Chuang CH, Chen CY. Assessing clinical outcomes of patiens with acute calculous cholecystitis in addition to the Tokyo grading: a retrospevtive study. Kaohsiung J Med Sci 2014; 30: 459-465.

9. Halldestan I, Enell, Kullman E, Borch K. Development of symtoms and complications in individuals with asymptomatic gallstones. Br J Surg 2004; 91: 734-738.

10. Rispoli C, Rocco N, Iannone L, et al. Developing guidelines in geriatric surgery: role of the grade system. BMC Geriatr. 9 (Suppl.1) (2009) A98.

11. Agrusa A, Romano G, Frazzetta G, et al. Role and outcomes of laparoscopic cholecstectomy in elderly. International Journal of Surgery 2014; 12: 537-539.

12. Marcari RS, Lupinacci RM, Nadal LR, Rego RE, Coelho AM, de Matos Farah JF. Outcomes of laparoscopic cholecystectomy in octogenarians. JSLS 2012; 16: 271-275.

13. Targarona EM, Ayuso RM, Bordas JM, et al. Randomised trial of endoscopic sphincterotomy with gallbladder left in situ versus open surgery for common bileduct in high-risk patients. Lancet 1996; 347: 926-929.

14. Boerma D, Rauws EA, Keulemans YC, et al. Waitand-see policy or laparoscopic cholecystectomy after endoscopic sphincterotomy for bile-duct stones: a randomised trial. Lancet 2002; 360: 761- 765.

15. Nielsen LB, Harboe KM, Bardram L. Cholecystectomy for the elderly: no hesitation for otherwise healthy patients. Surg Endosc 2014; 28: 171-177.

16. Rao A, Polanco A, Qiu S, et al. Safety of outpatient laparoscopic cholecystectomy in the elderly: analysis of 15,248 patients using the NSQIP database. J Am Coll Surg 2013; 217: 1038- 1043.
Eastern Journal of Medicine-Cover
  • ISSN: 1301-0883
  • Yayın Aralığı: 4
  • Başlangıç: 1996
  • Yayıncı: ERBİL KARAMAN
Sayıdaki Diğer Makaleler

Our Results On Cancellous Screw Fixation Of Femoral Neck Fractures In Adults

Tolgahan KURU

How Do The Diet, Oral Hygiene Habits And Body Mass Index Affect Tooth Caries In The Students Of The Faculty Of Dentistry?

Alperen DEĞİRMENCİ, Beyza ÜNALAN DEĞİRMENCİ

Orthodontic Camouflage Treatment of Skeletal Class III Malocclusion with Mandibular Bite Turbo Application

Saadet CINARSOY CIGERIM

A Case of Lung Adenocarcinoma Presenting as Miliary Appearance

Buket Mermit ÇİLİNGİR, Aysel SUNNETCİOGLU, Mesut ÖZGÖKÇE, İrfan BAYRAM

Thoracopagus: A Case of Conjoined Twins

Gökçe Naz KÜÇÜKBAŞ, Gurcan TURKYILMAZ, Güler ŞAHİN

Effectiveness of Self-adjusted Phosphate Binder Dose According to Dietary Phosphate Content Method In Improving Hyperphosphatemia Among Hemodialysis Patients

Su Mee KHOR, Chee Ping CHONG

Hemodynamic Monitoring Using A Pulse Counter Vigileo Flotrac Cardiac Output System In Transapical Off-Pump Minimally Invasive Mitral Valve Repair

Havva SAYHAN KAPLAN, Ümit KARADENİZ, Burak KAYA, Ali Fuat ERDEM, İbrahim KARA

Spinal Anesthesia Is Associated With Postoperative Urinary Retention In Women Undergoing Urogynecologic Surgery

Gulseren YILMAZ, Aysu AKÇA, Hüseyin KIYAK, Onur KARAASLAN, Ziya SALİHOĞLU

Preoperative Factors Associated with the Need for the Morcellation in Total Laparoscopic Hysterectomy

Hüseyin KIYAK, Onur KARAASLAN, Kerem SEÇKİN, Tolga KARACAN, Eser Sefik OZYUREK, Gulseren YILMAZ, Berk BULUT

Selecting The Arterial Cannulation Site In Acute Type A Aortic Dissection: Axillary Artery Or Femoral Artery?

Şahin ŞAHİNALP, Ali Kemal GÜR