Clinical outcome for laparoscopic cholecystectomy in extremely elderly patients.
OBJECTIVE
Extremely elderly patients who present with complicated gallstone disease are less likely to undergo definitive treatment. The use of laparoscopic cholecystectomy (LC) in older patients is complicated by comorbid conditions that are concomitant with advanced age and may increase postoperative complications and the frequency of conversion to open surgery. We aimed to evaluate the results of LC in patients (older than 80 years).


METHODS
We retrospectively analyzed 302 patients who underwent LC for acute cholecystitis between January 2011 and December 2013. Total patients were divided into three groups: group 1 patients were younger than 65 years, group 2 patients were between 65 and 79 years, and group 3 patients were older than 80 years. Patient characteristics were compared between the different groups.


RESULTS
The conversion rate was significantly higher in group 3 compared to that in the other groups. Hematoma in gallbladder fossa and intraoperative bleeding were higher in group 3, the difference was not significant. Wound infection was not different between the three groups. Operating time and postoperative hospital stay were significantly higher in group 3 compared to those in the other groups. There was no reported bile leakage and operative mortality. Preoperative percutaneous transhepatic gallbladder drainage and endoscopic retrograde cholangiopancreatography were performed more frequently in group 3 than in the other groups.


CONCLUSIONS
LC is safe and feasible. It should be the gold-standard approach for extremely elderly patients with acute cholecystitis.
Division of Hepatobiliary Surgery and Liver Transplantation, Department of Surgery, Chosun University Hospital, Gwangju, Korea.
Sang-Ill
SI
Lee
Division of Hepatobiliary Surgery and Liver Transplantation, Department of Surgery, Chosun University Hospital, Gwangju, Korea.
Byung-Gon
BG
Na
Division of Hepatobiliary Surgery and Liver Transplantation, Department of Surgery, Chosun University Hospital, Gwangju, Korea.
Young-Sun
YS
Yoo
Division of Hepatobiliary Surgery and Liver Transplantation, Department of Surgery, Chosun University Hospital, Gwangju, Korea.
Seong-Pyo
SP
Mun
Division of Hepatobiliary Surgery and Liver Transplantation, Department of Surgery, Chosun University Hospital, Gwangju, Korea.
Nam-Kyu
NK
Choi
80 and over aged; Laparoscopic cholecystectomy; Treatment outcome