Outcomes of cholecystectomy for treatment of acute cholecystitis in octogenarians.

Abstract

BACKGROUND:

The independent influence of advanced age on outcomes in contemporary series treated by early cholecystectomy is undetermined.

METHODS:

Elderly patients, aged 80 years and older, with histology proven acute cholecystitis treated by cholecystectomy on initial presentation between 2005 and 2011 were compared to all others.

RESULTS:

In total, 411 patients had histologically proven acute cholecystitis, of whom 71 (17%) were aged 80 years and older. Elderly patients were more likely to have ischaemic heart disease, underlying diabetes and chronic renal failure. There was greater conversion from laparoscopic to open surgery in the elderly (21% versus 7%; P = 0.001). Elderly patients were more likely to have gangrenous cholecystitis (44% versus 31%; P = 0.033) and common bile duct stones (27% versus 17%; P = 0.048). Elderly patients had more complications (31% versus 13%; P < 0.001), a higher mortality rate (4% versus 1%; P = 0.038) and a longer median post-operative length of stay (7 days versus 3 days; P < 0.001). Age ≥ 80 (P = 0.004) was an independent risk factors for complications.

CONCLUSION:

Age 80 years and older is independently associated with increased morbidity following cholecystectomy for treatment acute cholecystitis at initial presentation.

• Authors: Mehrdad Nikfarjam, David Yeo, Marcos Perini, Michael A Fink, Vijayaragavan Muralidharan, Graham Starkey, Robert M Jones, Christopher Christophi
• Journal: ANZ journal of surgery (ANZ J Surg) Vol. 84 Issue 12 Pg. 943-8 (Dec 2014) ISSN: 1445-2197 [Electronic] Australia
• PMID: 23910372 (Publication Type: Evaluation Study, Journal Article)
• Copyright: © 2013 Royal Australasian College of Surgeons.

Topics

• Age Factors
• Aged, 80 and over
• Cholecystectomy
• Cholecystectomy, Laparoscopic
• Cholecystitis, Acute (surgery)
• Conversion to Open Surgery (statistics & numerical data)
• Female
• Humans
• Male
• Postoperative Complications (epidemiology, etiology)
• Proportional Hazards Models
• Retrospective Studies
• Risk Factors
• Treatment Outcome