Complications of laparoscopic cholecystectomy in the ageing patient

Abstract

Aim: to determine the safety of simple laparoscopic cholecystectomy in ageing patients. Method: the outcome of patients between 60 and 70 years of age and patients over 70 who underwent laparoscopic cholecystectomy for symptomatic non-malignant gallbladder disease was comparatively analysed. All patients over 60 years of age with symptomatic gallbladder disease and without cholecholithiasis, septic shock, diffuse peritonitis, gallbladder malignancy, portal hypertension or contraindication for general anaesthesia were selected for simple laparoscopic cholecystectomy (n = 158). This group represents over 80% of all elderly patients undergoing biliary surgery at our department over this period. Group A (n = 97) included patients from 60 to 69 years of age. Group B (n = 61) comprised patients over 70 years. Results: there was no difference in sex distribution between groups. Operative time and conversion rates were similar in both groups. The overall morbidity rate was 14.5%, with no statistically significant increase in group B (11% for group A vs 20% for group B). No perioperative mortality occurred. Recurrent biliary surgery was required in two patients from group B (3%). Postoperative endoscopic retrograde cholangiography and sphincterotomy was done in four patients from group A (4%). The mean postoperative stay was longer for older patients (group A, 3.1 (2.5) days; group B, 4.2 (4.3) days; P= 0.05). Conclusion: simple laparoscopic cholecystectomy is safe in the aged, even for patients over 70. This procedure is associated with a short hospital stay and low rates of re-admission and recurrent biliary surgery.