title: [Acute cholecystitis and laparoscopic cholecystectomy in the elderly].
abstract: BACKGROUND
  The aim of this study was to assess the influence of age in laparoscopic cholecystectomy (LC) for the treatment of acute cholecystitis by determining the benefits and postoperative complications in patients older than 65 years.
  
  
  METHODS
  Between January 2003 and March 2006, we performed 134 urgent LC for acute cholecystitis: 58 patients older than 65 years (group 1) were compared with 76 patients younger than 65 years (group 2). Preoperative, intraoperative and postoperative variables were compared between groups 1 and 2. ASA score was used in the preoperative anesthetic evaluation.
  
  
  RESULTS
  A total of 31.2% of patients in group 1 had high surgical risk (24% ASA III and 9.2% ASA IV). The conversion rate was 24.1% in group 1 versus 11.3% in group 2 (p = 0.04), due to difficulty in surgical dissection and advanced cholecystitis. The mean length of postoperative hospital stay was 4.7 +/- 3.2 days in group 1 versus 3.3 +/- 2.4 days in group 2 (p = 0.001). The overall rate of postoperative complications was 33.1% and 18.7% respectively, with a predominance of infectious complications.
  
  
  CONCLUSIONS
  Although age should not be an exclusion factor for LC, the conversion rate, postoperative complications and length of hospital stay are increased in the elderly. Higher morbidity due to the underlying disease and longer disease duration with more advanced cholecystitis complicate the laparoscopic approach in these patients.
authors.affiliation: Unidad de Cirugía General y Urgencias, Hospital Universitario La Fe, Valencia, España. buenolledo@hotmail.com
authors.forename: Jose
authors.initials: J
authors.lastname: Bueno Lledó
authors.forename: Javier
authors.initials: J
authors.lastname: Vaqué Urbaneja
authors.forename: Conrado
authors.initials: C
authors.lastname: Herrero Bernabeu
authors.forename: Encarnación
authors.initials: E
authors.lastname: Castillo García
authors.forename: Fernando
authors.initials: F
authors.lastname: Carbonell Tatay
authors.forename: Ricardo
authors.initials: R
authors.lastname: Baquero Valdelomar
authors.forename: José
authors.initials: J
authors.lastname: Mir Pallardó
mesh_terms: D000368:Aged; D017081:Cholecystectomy, Laparoscopic / Q000379:methods*; D041881:Cholecystitis, Acute / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged