Outcomes of Laparoscopic Cholecystectomy in Patients 65 Years and Older

Abstract

Aim: Laparoscopic surgery is considered to be the gold standard in gall bladder surgery and to take advantage of its benefits, the number of laparoscopic procedures carried out on elderly patients is increasing daily. The aim of this study was to determine the mortality and morbidity rates of laparoscopic cholecystectomy (LC) in a patient group over 65 years of age and to analyze the predictive factors for conversion to open surgery. Study Design: A retrospective analysis of patients, 65 years of age and over, who had undergone laparoscopic cholecystectomy operation. Place and Duration of Study: Tepecik Training and Research Hospital, Department of General Surgery, Izmir, Turkey between January 2012 and June 2014 in our clinic was conducted. Methodology: A retrospective analysis of 385 patients, 65 years of age and over, who had undergone cholecystectomy operation When excluding the patients who had open cholecystectomy or additional surgical procedures, 240 patients were included in the study. The patients were also divided into two age groups (65-74 years; 75+ years) for further analysis. Results: The median age of the patients was 70. The rate of conversion from laparoscopy to open surgery was 12.5% (n=30). Multivariate analysis showed the leukocytosis and pathological acute cholecystitis to be independent risk factors for conversion. A longer total hospital stay was seen in patients with inflammatory bile duct diseases (5±4 days - 3±2 days). The surgical morbidity rate was 19.6% (n= 47); the rate of systemic complication was 2.5% (n=6). Conclusion: Inflammation related to gallstones in the biliary system is a definite risk factor for conversion to open surgery. Laparoscopic cholecystectomy, with its acceptable rates of morbidity, mortality and conversion, is a reliable surgical procedure in the 65 and over age group.