title: Complications of laparoscopic cholecystectomy in a geriatric population group.
abstract: The purpose of this study was to assess the complications of laparoscopic cholecystectomy among geriatric patients in New York State who receive their medical care under the Federal Medicare Program. A 20% random sample survey (304 patients) of the 1,520 patients who underwent laparoscopic cholecystectomy between January 1, 1990, and June 30, 1991, was selected. Coded ICD-9 diagnoses and procedures were carefully reviewed for these patients. In some patients with complications, the medical charts were reviewed by a medical epidemiologist and a surgeon to more fully elucidate the reported complications. The patients in this study were randomly selected from public, proprietary, voluntary, and teaching hospitals. Seventy-two complications (23.68% of the 304 patients) were identified in 48 patients (15.78% of the 304 patients). Of these complications, 27 (8.88%) were surgical, and 43 (14.14%) were medical in character. There were two deaths (0.66% of the 304 patients). Individual chart review of 32 of the 48 cases with complications revealed physician-related surgical quality-of-care problems which directly contributed to complications in 10 patients (31.25%). The overall complication rate of 23.68% found in this study represents one of the highest so far reported among published studies of laparoscopic cholecystectomy. The results of this study indicate a significant level of morbidity when laparoscopic cholecystectomy is performed on a geriatric population group. Although age-associated risk factors contributed to this high complication rate, so too did errors of surgical judgment and technique.(ABSTRACT TRUNCATED AT 250 WORDS)
authors: Island Peer Review Organization (IPRO), Lake Success, NY 11042.
authors: R P
authors: RP
authors: Nenner
authors: P J
authors: PJ
authors: Imperato
authors: C M
authors: CM
authors: Alcorn
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D017081:Cholecystectomy, Laparoscopic; D006801:Humans; D007431:Intraoperative Complications / Q000453:epidemiology*; D011183:Postoperative Complications / Q000453:epidemiology*