title: Outcome analysis of laparoscopic cholecystectomy in patients aged 80 years and older with complicated gallstone disease.
abstract: BACKGROUND
  The aim of this study was to evaluate the outcome of laparoscopic cholecystectomy (LC) in octogenarians with complicated gallstone disease.
  
  
  METHODS
  This study was a retrospective analysis of prospectively collected data of 51 patients aged 80 years or older who underwent an LC for complicated gallstone disease between 2001 and 2006. This group was compared with 41 octogenarian patients with uncomplicated gallstone disease.
  
  
  RESULTS
  There were 51 patients (26 men) with a median (range) age of 87 years (range, 80-93) who underwent an LC for complicated biliary disease, including acute cholecystitis in 29 (57%), gallstone pancreatitis in 14 (27%), cholangitis in 4 (7.8%), and obstructive jaundice in 4 (7.8%). Significantly more patients in the complicated disease group underwent preoperative endoscopic retrograde cholangiopancreatography (33.3% vs. 12.1%; P = 0.026) The median operative time was 110 minutes (range, 55-165) and this was significantly longer, compared to the uncomplicated disease group (P = 0.031). Postoperative morbidity was 27.3%, a significantly higher rate, compared to the uncomplicated group (27.4% vs. 7.3%; P = 0.015) with zero mortality. The conversion rate was 7.8% and this was not significantly different from the uncomplicated disease group. The median length of hospital stay was 6 days, which was significantly longer than the uncomplicated disease group (P = 0.021).
  
  
  CONCLUSIONS
  The LC can be performed with acceptable morbidity in octogenarians with complicated gallstone disease. Early treatment of gallstone disease in this age group could further improve outcomes.
authors.affiliation: Department of Surgery, University of Athens Medical School, Hippocration Hospital, Athens, Greece.
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Leandros
authors.forename: Nicholas
authors.initials: N
authors.lastname: Alexakis
authors.forename: Fotis
authors.initials: F
authors.lastname: Archontovasilis
authors.forename: Konstandinos
authors.initials: K
authors.lastname: Albanopoulos
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Dardamanis
authors.forename: Evangelos
authors.initials: E
authors.lastname: Menenakos
authors.forename: Christos
authors.initials: C
authors.lastname: Tsigris
authors.forename: Athanasios
authors.initials: A
authors.lastname: Giannopoulos
mesh_terms: D000369:Aged, 80 and over; D016009:Chi-Square Distribution; D017081:Cholecystectomy, Laparoscopic; D005260:Female; D042882:Gallstones / Q000150:complications / Q000601:surgery*; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D012189:Retrospective Studies; D018709:Statistics, Nonparametric; D016896:Treatment Outcome