Open Access, Peer-reviewed
pISSN 2288-6575
eISSN 2288-6796
    J Korean Surg Soc. 2009 Apr;76(4):231-235. Korean.
    Published online Apr 23, 2009.
    https://doi.org/10.4174/jkss.2009.76.4.231
    Copyright © 2009 The Korean Surgical Society
    Original Article

    Is Laparoscopic Cholecystectomy Safe in Octogenarians?

    Ja Yun Cho, M.D., Jong Yeol Kim, M.D., Su Kurn Chang, M.D., Sang Geol Kim, M.D., Yoon Jin Hwang, M.D. and Young Kook Yun, M.D.
      • Department of Surgery, Kyungpook National University Hospital, Kyungpook National University School of Medicine, Daegu, Korea.
    • Email: ksg@knu.ac.kr
    Received November 18, 2008; Accepted January 14, 2009.

    Abstract

    Purpose

    Biliary tract disease is one of the most common causes of acute abdominal pain in elderly patients, but there is still some debate over treatment. The aim of this study is to determine the safety and surgical outcomes of laparoscopic cholecystectomy (LC) for benign gallbladder disease in octogenarian patients.

    Methods

    We selected 42 patients of 80 years or older who underwent LC or open-converted cholecystectomy (OC) from February 1992 to November 2006. We evaluated clinicopathological features, treatment modalities, and surgical outcomes retrospectively.

    Results

    The patients included 17 males and 25 females. The mean age of the patients was 83.3 and 83.7, respectively. Right upper quadrant pain was the most common symptom, present in 85.7% of the patients. Gallstones were present in 85.7%. ASA class II and III comprised 92.9% of the patients. Comorbidities included hypertension, cardiac disease, pulmonary disease, and diabetes mellitus. Preoperatively biliary drainage was performed in 12 cases (endoscopic drainage in 8, percutaneous drainage in 4 cases). Preoperative cholecystostomy was performed in 5 cases. Emergency operations were more frequent than elective surgery (25 vs. 17). Mean hospital stay of LC patients was 5 days, whereas that of OC patients was 13 days. Open conversion rate was 16.7%. No surgical mortality was present and postoperative morbidity included acute myocardial infarction in one patient and wound infection in one patient.

    Conclusion

    LC in octogenarian patients was safe. However, since the incidence of comorbidities is high in these patients, great care should be taken to evaluate and manage the comorbidities before surgery.

    Keywords
    Laparoscopic cholecystectomy; Octogenarian

    Figures

    Fig. 1
    The difference of mean age, frequency of octogenarian, percentage of female in the patients who underwent laparoscopic cholecystectomy according to periods in Kyungpook National University Hospital (n=2,554). In 57 cases, operative date was not available. *Data are given as mean±SD.

    Tables

    Table 1
    Clinicopathological features of octogenarian patients who underwent laparoscopic cholecystectomy (n=42)

    Table 2
    Treatment modalities & surgical outcomes (n=42)

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    MeSH Terms
    Abdominal Pain
    Aged
    Aged, 80 and over
    Biliary Tract Diseases
    Cholecystectomy
    Cholecystectomy, Laparoscopic
    Cholecystostomy
    Comorbidity
    Diabetes Mellitus
    Drainage
    Emergencies
    Female
    Gallbladder Diseases
    Gallstones
    Heart Diseases
    Humans
    Hypertension
    Incidence
    Length of Stay
    Lung Diseases
    Male
    Myocardial Infarction
    Wound Infection
    Metrics
    Share
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