[Results of laparoscopic cholecystectomy for acute cholecystitis in elderly patients].
OBJECTIVE
The aim of this retrospective study was to evaluate the feasibility and the morbidity of laparoscopic cholecystectomy for acute cholecystitis in elderly patients.


METHODS
Among 891 consecutive patients who underwent cholecystectomy, 151 had acute cholecystitis. Fifty three patients of > or = 70 years of age (group 1) were compared to 98 younger patients (group 2). Analysis was made in "intention to treat" so directly open cholecystectomies during the same period were also included.


RESULTS
Elderly patients had a lower success rate of laparoscopic treatment (52.8% versus 70.4%; p < 0.05). This difference was due to higher rate of directly open cholecystectomy in the elderly (17% versus 2%). There was no difference between both groups in conversion rate to laparotomy (30.2% versus 26.5%). Surgical morbidity was 7.5% in group 1 and 4% in group 2 (NS). General complications were more frequent in the elderly (p < 0.05). Five patients in group 1 (9.4%) died of general complications of which 3 were operated on directly by open cholecystectomy. There was no mortality in group 2.


CONCLUSIONS
Acute cholecystitis in the elderly remains a severe disease in which laparoscopic treatment is only possible in about fifty percent.
Lucidarme
D
D
Département Médico-Chirurgical d'Hépato-Gastroentérologie, C.H. Saint Philibert, Lomme.
Corman
N
N
Courtade
A
A
Atat
I
I
Forzy
G
G
Filoche
B
B
Desrousseaux
B
B
D000208:Acute Disease; D000368:Aged; D001145:Arrhythmias, Cardiac / Q000150:complications; D002760:Cholangiopancreatography, Endoscopic Retrograde; D002763:Cholecystectomy; D017081:Cholecystectomy, Laparoscopic / Q000009:adverse effects; D002764:Cholecystitis / Q000473:pathology / Q000601:surgery*; D000075202:Contraindications; D005069:Evaluation Studies as Topic; D005240:Feasibility Studies; D005734:Gangrene; D006801:Humans; D007431:Intraoperative Complications; D007813:Laparotomy; D008875:Middle Aged; D011183:Postoperative Complications; D012189:Retrospective Studies; D016717:Sphincterotomy, Endoscopic; D015996:Survival Rate; D016896:Treatment Outcome
Résultats de la cholécystectomie coelioscopique pour cholécystite aiguë chez le sujet âgé.