title: Laparoscopic cholecystectomy for acute cholecystitis in the elderly.
abstract: This study reviewed the results of laparoscopic cholecystectomy for acute cholecystitis in the elderly. Among 557 patients who underwent laparoscopic cholecystectomy, 70 (12.6%) had a clinical diagnosis of acute cholecystitis confirmed by ultrasonography. There were 28 men and 42 women with a mean age of 59.9 years (range 20-87 years). Thirty patients >/= 65 years of age were compared to 40 patients < 65 years old. Elderly patients had a higher female predominance (p < 0.05), a higher incidence of intercurrent diseases (p < 0.05), and a higher serum urea level (p < 0.001). The proportions of patients who underwent early or delayed surgery were comparable. There was no difference in operation time, postoperative analgesic requirements, or complications. Elderly patients, however, had a significantly higher conversion rate (23.3% versus 2.5%;p < 0.05). Even after successful laparoscopic cholecystectomy, there was a longer delay before ambulation (p < 0.05) and resumption of normal diet (p = 0. 08) with resulting prolonged postoperative (p = 0.08) and total hospital stay (p < 0.05). Laparoscopic cholecystectomy is a safe, effective treatment for acute cholecystitis in the elderly. When compared to younger patients, elderly patients are at greater risk for conversion, delayed recovery, and prolonged hospital stay.
authors.affiliation: Department of Surgery, The University of Hong Kong, Queen Mary Hospital, Hong Kong.
authors.forename: C M
authors.initials: CM
authors.lastname: Lo
authors.forename: E C
authors.initials: EC
authors.lastname: Lai
authors.forename: S T
authors.initials: ST
authors.lastname: Fan
authors.forename: C L
authors.initials: CL
authors.lastname: Liu
authors.forename: J
authors.initials: J
authors.lastname: Wong
mesh_terms: D000208:Acute Disease; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002760:Cholangiopancreatography, Endoscopic Retrograde; D017081:Cholecystectomy, Laparoscopic / Q000379:methods*; D002764:Cholecystitis / Q000175:diagnosis / Q000601:surgery*; D003135:Common Bile Duct / Q000000981:diagnostic imaging; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome; D014463:Ultrasonography