Cholecystectomy for gallbladder disease in elderly aged 80 years and over.
OBJECTIVE
Patients aged 80 years and over show greater risk of complicated gallbladder diseases and associated comorbidities. The aim of the study is to evaluate the prognosis after laparoscopic or open cholecystectomy in these patients.


METHODS
100 patients aged between 80 and 92 years (group 1) and 241 patients aged between 70 and 79 years (group 2), undergoing cholecystectomy for gallbladder disease, are the subject of the study. Types of disease and surgery and p.o. morbidity and mortality have been evaluated.


RESULTS
The patients of group 1 have shown a significant greater incidence of p.o. morbidity (20%) than group 2 (2.3%) (chi2 = 39.5; p < 0.001), regardless to the type of cholecystectomy. Endoscopic sphincterotomy for lithiasis of common biliary duct seems an important risk factor (chi2 = 7.1; p < 0.001). In group 2, the morbidity rate after laparoscopic cholecystectomy was lesser than after open surgery (X2=5.3; p < 0.02). In both groups, postoperative hospital stay was longer after open cholecystectomy and endoscopic sphincterotomy.


CONCLUSIONS
Patients aged 80 years and over, undergoing cholecystectomy, specially after endoscopic sphinterotomy., have a greater risk of p.o. morbidity and mortality than younger. Laparoscopic and open cholecystectomy seems to bear the same poor p.o. prognosis.
Leardi
Sergio
S
Geriatric Surgery, Department of Surgical Science, University of L'Aquila, p.S.Tomassi,1, L'Aquila, Italy. serglear@tin.it
De Vita
Fabiola
F
Pietroletti
Renato
R
Simi
Mario
M
D000369:Aged, 80 and over; D016009:Chi-Square Distribution; D002763:Cholecystectomy / Q000379:methods*; D017081:Cholecystectomy, Laparoscopic; D005260:Female; D005705:Gallbladder Diseases / Q000601:surgery*; D006801:Humans; D008297:Male; D011183:Postoperative Complications; D011379:Prognosis; D012307:Risk Factors; D016896:Treatment Outcome