Laparoscopic cholecystectomy for acute cholecystitis in elderly patients.
BACKGROUND
Acute cholecystitis is the major complication of biliary lithiasis, for which laparoscopic treatment has been established as the standard therapy. With longer life expectancy, acute cholecystitis has often been seen in elderly patients (>65 years old) and is often accompanied by comorbity and severe complications. We sought to compare the outcome of laparoscopic treatment for acute cholecystitis with special focus on comparison between elderly and nonelderly patients.


METHODS
This study was a prospective analysis of 190 patients who underwent laparoscopic cholecystectomy due to acute cholecystitis or chronic acute cholecystitis, comparing elderly and nonelderly patients.


RESULTS
Of 190 patients, 39 (21%) were elderly (>65 years old) and 151 (79%) were not elderly (< or =65 years), with conversion rates of 10.3% and 6.6% (P=0.49), respectively. The incidence of postoperative complications in elderly and nonelderly patients were the following, respectively: atelectasis 5.1% and 2.0% (P=0.27); respiratory infection 5.1% and 2.7% (P=0.6); bile leakage 5.1% and 2.0% (P=0.27), and intraabdominal abscess 1 case (0.7%) and no incidence (P = 1).


CONCLUSIONS
According to our data, laparoscopic cholecystectomy is a safe and efficient procedure for the treatment of acute cholecystitis in patients older than 65 years of age.
do Amaral
Paulo Cézar Galvão
PC
General Surgery Division, São Rafael Hospital, Department of Surgery, Escola Bahiana de Medicina e Saúde Pública, Salvador, Bahia, Brazil. pcgamaral@terra.com.br
Azaro Filho
Euler de Medeiros
Ede M
Galvão
Thales Delmondes
TD
Ettinger
João Eduardo Marques de Menezes
JE
Silva Reis
Jadson Murilo
JM
Lima
Marcos
M
Fahel
Edvaldo
E
D000368:Aged; D000369:Aged, 80 and over; D016009:Chi-Square Distribution; D017081:Cholecystectomy, Laparoscopic; D041881:Cholecystitis, Acute / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011446:Prospective Studies; D016896:Treatment Outcome