title: Role and outcomes of laparoscopic cholecystectomy in the elderly.
abstract: BACKGROUND
  Laparoscopic cholecystectomy is the standard of treatment for gallstones disease and acute colecystitis. The prevalence of this disease increases with age and the population is aging in industrialized countries. So, in this study we report our experience in the treatment of gallstone disease in elderly patients, particularly analyzing the outcomes of laparoscopic approach.
  
  
  METHODS
  Between January 2010 and May 2014 we performed a total of 1227 cholecystectomies. In this retrospective study age group was the primary independent variable: 351 patients were 65-79 years of age and 65 were 80 years of age or older.
  
  
  RESULTS
  Only 65 patients (5.3%) of all population had primary open cholecystectomy, but the rate in young group was 3.7% respect the highest frequency (9.2%) in the elderly group. The conversion rate was higher (1.2%) in the older group but there was no significant difference with younger group. LC in emergency setting was performed in 10.3% of young patients and in 13.8% of elderly group.
  
  
  CONCLUSIONS
  Laparoscopic cholecystectomy is a feasible and safe procedure in elderly patients and might be performed during the same hospitalization like definitive treatment of gallstone disease. The old age and subsequent comorbidity are the fundamental predictor of surgical outcomes. Elective treatment should be recommended when repeated gallstone symptoms have occurred in the elderly patient before the development of acute cholecystitis and related complications.
authors.affiliation: Department of General Surgery, Urgency and Organ Transplantation, University of Palermo, Via L. Giuffrè, 5, 90127 Palermo, Italy. Electronic address: antonino.agrusa@unipa.it.
authors.forename: Antonino
authors.initials: A
authors.lastname: Agrusa
authors.affiliation: Department of General Surgery, Urgency and Organ Transplantation, University of Palermo, Via L. Giuffrè, 5, 90127 Palermo, Italy. Electronic address: giorgio.romano@unipa.it.
authors.forename: Giorgio
authors.initials: G
authors.lastname: Romano
authors.affiliation: Department of General Surgery, Urgency and Organ Transplantation, University of Palermo, Via L. Giuffrè, 5, 90127 Palermo, Italy. Electronic address: giuseppe.frazzetta@libero.it.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Frazzetta
authors.affiliation: Department of General Surgery, Urgency and Organ Transplantation, University of Palermo, Via L. Giuffrè, 5, 90127 Palermo, Italy. Electronic address: chianetta83@libero.it.
authors.forename: Daniela
authors.initials: D
authors.lastname: Chianetta
authors.affiliation: Department of General Surgery, Urgency and Organ Transplantation, University of Palermo, Via L. Giuffrè, 5, 90127 Palermo, Italy. Electronic address: vincenzosorce@me.com.
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Sorce
authors.affiliation: Department of General Surgery, Urgency and Organ Transplantation, University of Palermo, Via L. Giuffrè, 5, 90127 Palermo, Italy. Electronic address: g.dibuono@libero.it.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Di Buono
authors.affiliation: Department of General Surgery, Urgency and Organ Transplantation, University of Palermo, Via L. Giuffrè, 5, 90127 Palermo, Italy. Electronic address: gaspare.gulotta@unipa.it.
authors.forename: Gaspare
authors.initials: G
authors.lastname: Gulotta
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002763:Cholecystectomy; D017081:Cholecystectomy, Laparoscopic / Q000379:methods*; D041881:Cholecystitis, Acute / Q000601:surgery*; D002769:Cholelithiasis / Q000601:surgery*; D015331:Cohort Studies; D015897:Comorbidity; D061887:Conversion to Open Surgery / Q000706:statistics & numerical data; D017558:Elective Surgical Procedures; D005260:Female; D042882:Gallstones / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome
keywords: Gallstone disease-elderly; Geriatric surgery; Laparoscopic cholecystectomy; Laparoscopic surgery; Laparoscopy