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Published in: World Journal of Surgery 7/2006

01-07-2006 | ORIGINAL SCIENTIFIC REPORTS

Laparoscopic Cholecystectomy in Patients Aged 80 Years and Over

Authors: A-Hon Kwon, MD, Yoichi Matsui, MD

Published in: World Journal of Surgery | Issue 7/2006

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Abstract

Introduction

The aging population has led to a significant rise in the number of patients undergoing operations such as cholecystectomy. We have evaluated and compared the results of laparoscopic cholecystectomy (LC) in patients aged 80 years and over with those of patients aged between 65 and 79 years.

Methods

A total of 471 patients aged 65 to 79 years (group 1) and 45 patients aged ≥80 years (group 2) underwent LC. All patients underwent preoperative spiral computed tomography after intravenous infusion cholangiography and intraoperative cholangiography.

Results

There was a higher incidence of choledocholithiasis and gallbladder cancer in the patients ≥80 years of age. In addition, group 2 patients had a higher incidence of cardiopulmonary disease and higher American Association of Anesthesiology scores than did those in group 1. With respect to the conversion rate to open surgery, morbidity, mortality, and length of hospital stay, there were no significant differences between the two groups. There was a significantly higher incidence of positive bile cultures and gram-negative rods in group 2 patients than in those in group 1.

Conclusions

Octogenarians tolerated LC well. Therefore, early elective LC should be encouraged to minimize morbidity and mortality in these elderly patients who have symptomatic cholelithiasis.
Literature
2.
go back to reference Bennion LJ, Grundy SM. Risk factors for the development of cholelithiasis in man. N Engl J Med 1979;299:1221–1227CrossRef Bennion LJ, Grundy SM. Risk factors for the development of cholelithiasis in man. N Engl J Med 1979;299:1221–1227CrossRef
3.
go back to reference Bufalari A, Cao MF, Cirocchi R, et al. Surgical care in octogenarians. Br J Surg 1996;83:1783–1787PubMed Bufalari A, Cao MF, Cirocchi R, et al. Surgical care in octogenarians. Br J Surg 1996;83:1783–1787PubMed
4.
go back to reference Sandler RS, Maule WF, Baltus ME, et al. Biliary tract surgery in the elderly. J Gen Intern Med 1987;2:149–154PubMed Sandler RS, Maule WF, Baltus ME, et al. Biliary tract surgery in the elderly. J Gen Intern Med 1987;2:149–154PubMed
5.
go back to reference Huber DF, Martin EW, Cooperman M. Cholecystectomy in elderly patients. Am J Surg 1983;146:719–721PubMedCrossRef Huber DF, Martin EW, Cooperman M. Cholecystectomy in elderly patients. Am J Surg 1983;146:719–721PubMedCrossRef
6.
go back to reference Lujan JA, Sanchez-Bueno F, Parrilla P, et al. Laparoscopic vs open cholecystectomy in patients aged 65 and older. Surg Laparosc Endosc 1998;8:208–210PubMedCrossRef Lujan JA, Sanchez-Bueno F, Parrilla P, et al. Laparoscopic vs open cholecystectomy in patients aged 65 and older. Surg Laparosc Endosc 1998;8:208–210PubMedCrossRef
7.
go back to reference Fried GM, Clas D, Meakins JL. Minimally invasive surgery in the elderly patient. Surg Clin North Am 1994;74:375–387PubMed Fried GM, Clas D, Meakins JL. Minimally invasive surgery in the elderly patient. Surg Clin North Am 1994;74:375–387PubMed
8.
go back to reference Magnuson TH, Ratner LE. Zenilman ME. Laparoscopic cholecystectomy: applicability in the geriatric population. Am Surg 1997;117:156–164 Magnuson TH, Ratner LE. Zenilman ME. Laparoscopic cholecystectomy: applicability in the geriatric population. Am Surg 1997;117:156–164
9.
go back to reference Kwon AH, Uetsuji S, Yamada O, et al. Three-dimensional reconstruction of the biliary tract using spiral computed tomography. Br J Surg 1995;82:260–263PubMed Kwon AH, Uetsuji S, Yamada O, et al. Three-dimensional reconstruction of the biliary tract using spiral computed tomography. Br J Surg 1995;82:260–263PubMed
10.
go back to reference Kwon AH, Uetsuji S, Ogura T, et al. Spiral computed tomography scanning after intravenous infusion cholangiography for biliary duct anomalies. Am J Surg 1997;174:396–401PubMed Kwon AH, Uetsuji S, Ogura T, et al. Spiral computed tomography scanning after intravenous infusion cholangiography for biliary duct anomalies. Am J Surg 1997;174:396–401PubMed
11.
go back to reference American Joint Committee on Cancer. AJCC Cancer Staging Manual, 5th edition. Lippincott-Raven, Philadelphia, 1997;103–105 American Joint Committee on Cancer. AJCC Cancer Staging Manual, 5th edition. Lippincott-Raven, Philadelphia, 1997;103–105
12.
go back to reference Brunt LM, Quasebarth DL, Dunnegan DL, et al. Outcomes analysis of laparoscopic cholecystectomy in the extremely elderly. Surg Endosc 2001;15:700–705PubMedCrossRef Brunt LM, Quasebarth DL, Dunnegan DL, et al. Outcomes analysis of laparoscopic cholecystectomy in the extremely elderly. Surg Endosc 2001;15:700–705PubMedCrossRef
13.
go back to reference Shamburek RD, Farrar JT. Disorders of the digestive system in the elderly. N Engl J Med 1990;322:438–443PubMedCrossRef Shamburek RD, Farrar JT. Disorders of the digestive system in the elderly. N Engl J Med 1990;322:438–443PubMedCrossRef
14.
go back to reference Kahng KU, Roslyn JJ. Surgical issues for the elderly patient with hepatobiliary disease. Surg Clin North Am 1994;74:345–373PubMed Kahng KU, Roslyn JJ. Surgical issues for the elderly patient with hepatobiliary disease. Surg Clin North Am 1994;74:345–373PubMed
15.
go back to reference Rege RV. Asymptomatic gallstones. In: Cameron JL, editor, Current Surgical Therapy, 6th edition. St. Louis, Mosby–Year Book, 1998;403–405 Rege RV. Asymptomatic gallstones. In: Cameron JL, editor, Current Surgical Therapy, 6th edition. St. Louis, Mosby–Year Book, 1998;403–405
16.
go back to reference Harness JK, Strodel WE, Talsma SE. Symptomatic biliary tract disease in the elderly patient. Am Surg 1986;52:442–445PubMed Harness JK, Strodel WE, Talsma SE. Symptomatic biliary tract disease in the elderly patient. Am Surg 1986;52:442–445PubMed
17.
go back to reference Firilas A, Duke BE, Max MH. Laparoscopic cholecystectomy in the elderly. Surg Endosc 1996;10:33–35PubMedCrossRef Firilas A, Duke BE, Max MH. Laparoscopic cholecystectomy in the elderly. Surg Endosc 1996;10:33–35PubMedCrossRef
18.
go back to reference Behrman SW, Melvin WS, Babb ME, et al. Laparoscopic cholecystectomy in the geriatric population. Am Surg 1996;62:386–390PubMed Behrman SW, Melvin WS, Babb ME, et al. Laparoscopic cholecystectomy in the geriatric population. Am Surg 1996;62:386–390PubMed
19.
go back to reference Pessaux P, Tuech JJ, Derouet N, et al. Laparoscopic cholecystectomy in the elderly: a prospective study. Surg Endosc 2000;14:1067–1069PubMed Pessaux P, Tuech JJ, Derouet N, et al. Laparoscopic cholecystectomy in the elderly: a prospective study. Surg Endosc 2000;14:1067–1069PubMed
20.
go back to reference Tagle FM, Lavergne J, Barkin JS, et al. Laparoscopic cholecystectomy in the elderly. Surg Endosc 1997;11:636–638PubMedCrossRef Tagle FM, Lavergne J, Barkin JS, et al. Laparoscopic cholecystectomy in the elderly. Surg Endosc 1997;11:636–638PubMedCrossRef
21.
go back to reference Askew AR. Surgery for gallstones in the elderly. Aust N Z J Surg 1995;65:312–315PubMed Askew AR. Surgery for gallstones in the elderly. Aust N Z J Surg 1995;65:312–315PubMed
22.
go back to reference Maxwell JG, Tyler BA, Maxwell BG, et al. Laparoscopic cholecystectomy in octogenarians. Am Surg 1998;64:826–832PubMed Maxwell JG, Tyler BA, Maxwell BG, et al. Laparoscopic cholecystectomy in octogenarians. Am Surg 1998;64:826–832PubMed
23.
go back to reference Kwon AH, Matsui Y, Uemura Y. Surgical procedures and histopathologic findings for patients with xanthogranulomatous cholecystitis. J Am Coll Surg 2004;199:204–210PubMedCrossRef Kwon AH, Matsui Y, Uemura Y. Surgical procedures and histopathologic findings for patients with xanthogranulomatous cholecystitis. J Am Coll Surg 2004;199:204–210PubMedCrossRef
24.
go back to reference Tomikawa M, Kitano S, Iso Y, et al. Feasibility of laparoscopic cholecystectomy for patients with a nonvisualized gallbladder on drip infusion cholangiography. Surg Laparosc Endosc 1995;5:121–124PubMed Tomikawa M, Kitano S, Iso Y, et al. Feasibility of laparoscopic cholecystectomy for patients with a nonvisualized gallbladder on drip infusion cholangiography. Surg Laparosc Endosc 1995;5:121–124PubMed
25.
go back to reference Kwon AH, Inui H, Imamura A, et al. Preoperative assessment for laparoscopic cholecystectomy: feasibility of using spiral computed tomography. Ann Surg 1998;227:351–356PubMedCrossRef Kwon AH, Inui H, Imamura A, et al. Preoperative assessment for laparoscopic cholecystectomy: feasibility of using spiral computed tomography. Ann Surg 1998;227:351–356PubMedCrossRef
26.
go back to reference Uecker J, Adams M, Skipper K, et al. Cholecystitis in the octogenarian: is laparoscopic cholecystectomy the best approach? Am Surg 2001;67:637–640PubMed Uecker J, Adams M, Skipper K, et al. Cholecystitis in the octogenarian: is laparoscopic cholecystectomy the best approach? Am Surg 2001;67:637–640PubMed
27.
go back to reference Maxwell JG, Tyler BA, Rutledge R, et al. Cholecystectomy in patients aged 80 and older. Am J Surg 1998;176:627–631PubMedCrossRef Maxwell JG, Tyler BA, Rutledge R, et al. Cholecystectomy in patients aged 80 and older. Am J Surg 1998;176:627–631PubMedCrossRef
28.
go back to reference Laycock WS, Siewers AE, Birkmeyer CM, et al. Variation in the use of laparoscopic cholecystectomy for elderly patients with acute cholecystitis. Arch Surg 2000;135:457–462PubMedCrossRef Laycock WS, Siewers AE, Birkmeyer CM, et al. Variation in the use of laparoscopic cholecystectomy for elderly patients with acute cholecystitis. Arch Surg 2000;135:457–462PubMedCrossRef
29.
go back to reference Weber DM. Laparoscopic surgery: an excellent approach in elderly patients. Arch Surg 2003;138:1083–1088PubMedCrossRef Weber DM. Laparoscopic surgery: an excellent approach in elderly patients. Arch Surg 2003;138:1083–1088PubMedCrossRef
30.
go back to reference Krarup T, Sønderstrup J, Kruse-Blinkenberg HO, et al. Surgery for gallstones in old age: do we operate too late? Acta Chir Scand 1982;148:263–266PubMed Krarup T, Sønderstrup J, Kruse-Blinkenberg HO, et al. Surgery for gallstones in old age: do we operate too late? Acta Chir Scand 1982;148:263–266PubMed
Metadata
Title
Laparoscopic Cholecystectomy in Patients Aged 80 Years and Over
Authors
A-Hon Kwon, MD
Yoichi Matsui, MD
Publication date
01-07-2006
Publisher
Springer-Verlag
Published in
World Journal of Surgery / Issue 7/2006
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI
https://doi.org/10.1007/s00268-005-0413-2

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