World journal of gastroenterology · 2009
Outcome of laparoscopic cholecystectomy is not influenced by chronological age in the elderly.
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Kim Hyung-Ook, Yun Jung-Won, Shin Jun-Ho, Hwang Sang-Il, Cho Yong-Kyun, Son Byung-Ho, Yoo Chang-Hak, Park Yong-Lai, Kim Hungdai
Аннотация
AIM: To evaluate the outcome of laparoscopic cholecystectomy (LC) in patients aged 80 years and older.
METHODS: A total of 353 patients aged 65 to 79 years (group 1) and 35 patients aged 80 years and older (group 2) underwent LC. Patients were further classified into two other groups: those with uncomplicated gallbladder disease (group A) or those with complicated gallbladder disease (group B).
RESULTS: There were no significant differences between the age groups (groups 1 and 2) with respect to clinical characteristics such as age, gender, comorbid disease, or disease presentation. Mean operative time, conversion rate, and the incidence of major postoperative complications were similar in groups 1 and 2. However, the percentage of high-risk patients was significantly higher in group 2 than in group 1 (20.0% vs 5.7%, P < 0.01). Group A comprised 322 patients with a mean age of 71.0 +/- 5.3 years, and group B comprised 51 patients with a mean age of 69.9 +/- 4.8 years. In group B, mean operative time (78.4 +/- 49.3 min vs 58.3 +/- 35.8 min, P < 0.01), mean postoperative hospital stay (7.9 +/- 6.5 d vs 5.0 +/- 3.7 d, P < 0.01), and the incidence of major postoperative complications (9.8% vs 3.1%, P < 0.05) were significantly greater than in group A. The conversion rate tended to be higher in group B, but this difference was not significant.
CONCLUSION: Perioperative outcomes in elderly patients who underwent LC seem to be influenced by the severity of gallbladder disease, and not by chronologic age. In octogenarians, LC should be performed at an earlier, uncomplicated stage of the disease whenever possible to improve perioperative outcomes.
METHODS: A total of 353 patients aged 65 to 79 years (group 1) and 35 patients aged 80 years and older (group 2) underwent LC. Patients were further classified into two other groups: those with uncomplicated gallbladder disease (group A) or those with complicated gallbladder disease (group B).
RESULTS: There were no significant differences between the age groups (groups 1 and 2) with respect to clinical characteristics such as age, gender, comorbid disease, or disease presentation. Mean operative time, conversion rate, and the incidence of major postoperative complications were similar in groups 1 and 2. However, the percentage of high-risk patients was significantly higher in group 2 than in group 1 (20.0% vs 5.7%, P < 0.01). Group A comprised 322 patients with a mean age of 71.0 +/- 5.3 years, and group B comprised 51 patients with a mean age of 69.9 +/- 4.8 years. In group B, mean operative time (78.4 +/- 49.3 min vs 58.3 +/- 35.8 min, P < 0.01), mean postoperative hospital stay (7.9 +/- 6.5 d vs 5.0 +/- 3.7 d, P < 0.01), and the incidence of major postoperative complications (9.8% vs 3.1%, P < 0.05) were significantly greater than in group A. The conversion rate tended to be higher in group B, but this difference was not significant.
CONCLUSION: Perioperative outcomes in elderly patients who underwent LC seem to be influenced by the severity of gallbladder disease, and not by chronologic age. In octogenarians, LC should be performed at an earlier, uncomplicated stage of the disease whenever possible to improve perioperative outcomes.