Impact of the introduction of laparoscopic cholecystectomy on the population aged 70 and over.
OBJECTIVE
Laparoscopic cholecystectomy is reported to be better tolerated than open cholecystectomy by patients aged 70 and over. We evaluate its impact on patients aged 70 and over, from one single center.


METHODS
We review 427 cholecystectomies performed in one single centre, from November 1992 through November 1999. We consider 23 patients, 70 years old or older at the time of surgery. The following objective parameters were considered and compared with the younger population: length of stay in the hospital; mean preoperative stay; mean postoperative stay; incidence of risk factors; postoperative complications. A questionnaire was also mailed to all individual 427 patients.


RESULTS
Length of stay in the hospital declined in both population, during the time interval considered. The incidence of risk factors, both major and minor, increases consistently with age from less than 1% below the age of 30 to about 62% in the eighth decade and over. Major postoperative complications were 4.34% in patients > or = 70 vs. 2.8% in patients < 70 years of age. Mortality was nil in both groups. Ninety percent reported complete disappearance of preoperative symptoms.


CONCLUSIONS
Laparoscopic cholecystectomy in geriatric patients is safe and risks are reasonably low. Selection of patients must be done on strict indications.
Elli
M
M
Universitá degli Studi di Milano Ospedale Luigi Sacco, via G.B. Grassi, 72-20157 Milano, Italy. Marco.Elli@unimi.it
Poliziani
D
D
Colli Franzone
P
P
Vignati
G A
GA
Taschieri
A M
AM
D000368:Aged; D000369:Aged, 80 and over; D017081:Cholecystectomy, Laparoscopic / Q000706:statistics & numerical data; D002769:Cholelithiasis / Q000401:mortality / Q000601:surgery*; D005260:Female; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D011183:Postoperative Complications / Q000209:etiology* / Q000401:mortality; D012307:Risk Factors; D016019:Survival Analysis; D016896:Treatment Outcome