[Is there an age limit for laparoscopic cholecystectomy? Apropos of 61 patients over 85 years of age].
Bilary surgery in the elderly is associated with high morbidity and mortality. The aim of this prospective study was to determine benefits of laparoscopic cholecystectomy in patients over 85 years. From August 1990 to January 1996, 61 patients (50 women, 11 men) aged over 85 years had laparoscopic cholecystectomy. Thirty seven (60.6%) were at high surgical risk (ASA III). In more than 40% of cases complications were present (acute cholecystitis, gallbladder empyema). Nine patients (14.7%) had choledocholithiasis. Ten (16.3%) conversions were necessary, in 5 cases for choledocholithiasis. Overall morbidity was 9.8%: 2 bibary leaks, 1 pneumonia, 1 urinary injection and 1 lymphangitis. There was no mortality. With excellent pre-operative risk evaluation, laparoscopic cholecystectomy is better than laparotomy cholecystectomy. Laparoscopic cholecystectomy has a low morbidity in the elderly and it allows curative treatment of gallstones complicated or not.
Barrat
C
C
Service de Chirurgie Générale, Université Paris XII, UFR Bobigny, Hôpital Jean Verdier, Bondy.
Turner
R
R
Rizk
N
N
Vinurel
M
M
Champault
G
G
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001660:Biliary Tract Diseases / Q000601:surgery; D002763:Cholecystectomy / Q000009:adverse effects / Q000379:methods; D017081:Cholecystectomy, Laparoscopic / Q000009:adverse effects; D005260:Female; D006801:Humans; D007432:Intraoperative Period; D007902:Length of Stay; D008297:Male; D012189:Retrospective Studies; D012308:Risk Management; D016896:Treatment Outcome