title: Laparoscopic cholecystectomy in elderly patients: an evaluation of immunity.
abstract: OBJECTIVE
  We sought to investigate the impact of laparoscopic cholecystectomy (LC) on the inflammatory response and immunological function of elderly patients compared with that on the younger ones.
  
  
  METHODS
  Between June 2012 and June 2013, this prospective study investigated a total of 112 patients having the surgery of LC due to symptomatic cholelithiasis or polyps, among whom 52 were elderly patients with the age beyond 65 years old and the remaining 60 were younger than the age. Peripheral venous blood samples were taken from these patients prior to surgery and on post-operative days 1, 3 and 7, respectively. The perioperative clinical outcomes and immunological function results were analyzed and compared between the two groups divided by age.
  
  
  RESULTS
  The demographics of the two groups did not differ except for the age. Surgical trauma seemed more serious for elderly patients as illustrated by the longer operating time, hospital stay and more quantity of patients got complication. Both groups indicated changes in inflammatory and immune aspects. Compared with the younger ones, elderly patients showed less quantity of preoperative basic immune cells, delayed immune responses after the surgical trauma of LC and hyporeactivity of inflammatory response when accepting LC.
  
  
  CONCLUSIONS
  An examination of the inflammatory reaction and immune response after LC demonstrated that there are significant differences observed in two groups divided by age. Further studies with more samples are required to determine the exact relationship of perioperative immune change and higher adverse outcome rate of aged people.
authors.affiliation: Medical School of Chinese People's Liberation Army, Haidian district, Beijing, 100853, China.|Department of Hepatobiliary Surgery, The 309th Hospital of Chinese People's Liberation Army, Haidian district, Beijing, 100091, China.
authors.forename: Hong-Qiang
authors.initials: HQ
authors.lastname: Zhao
authors.affiliation: Department of Hepatobiliary Surgery, The 309th Hospital of Chinese People's Liberation Army, Haidian district, Beijing, 100091, China.
authors.forename: Hao-Run
authors.initials: HR
authors.lastname: Liu
authors.affiliation: Military Organ Transplantation Center, The 309th Hospital of Chinese People's Liberation Army, Haidian district, Beijing, 100091, China.
authors.forename: Li
authors.initials: L
authors.lastname: Xiao
authors.affiliation: Department of Hepatobiliary Surgery, The 309th Hospital of Chinese People's Liberation Army, Haidian district, Beijing, 100091, China.
authors.forename: Fang
authors.initials: F
authors.lastname: Zheng
authors.affiliation: Department of Hepatobiliary Surgery, The 309th Hospital of Chinese People's Liberation Army, Haidian district, Beijing, 100091, China. weiminlicn@126.com.
authors.forename: Wei-Min
authors.initials: WM
authors.lastname: Li
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000375:Aging / Q000276:immunology*; D002681:China / Q000453:epidemiology; D017081:Cholecystectomy, Laparoscopic / Q000009:adverse effects / Q000379:methods; D041881:Cholecystitis, Acute / Q000453:epidemiology / Q000276:immunology / Q000601:surgery; D002769:Cholelithiasis / Q000453:epidemiology / Q000276:immunology / Q000601:surgery; D005260:Female; D006801:Humans; D007159:Immunologic Tests / Q000379:methods / Q000706:statistics & numerical data; D007249:Inflammation / Q000276:immunology*; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology / Q000276:immunology; D011184:Postoperative Period; D011300:Preoperative Care / Q000379:methods; D011446:Prospective Studies; D012307:Risk Factors
keywords: Elderly; Immune responses; Immunosenescence; Inflammation; Laparoscopic cholecystectomy