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Surgical Endoscopy

, Volume 27, Issue 4, pp 1144–1150 | Cite as

Frailty predicts outcome of elective laparoscopic cholecystectomy in geriatric patients

  • Konstantinos LasithiotakisEmail author
  • John Petrakis
  • Maria Venianaki
  • George Georgiades
  • Dimosthenis Koutsomanolis
  • Alexander Andreou
  • Odysseas Zoras
  • George Chalkiadakis
Article

Abstract

Background

Frailty is a phenotype characterized by complex and challenging medical problems and higher susceptibility to adverse health outcomes. It can be derived at by a multidimensional process known as comprehensive geriatric assessment (CGA), which assesses the functional reserves of the elderly. In this study we report for the first time on a prospective evaluation of the association between CGA and postoperative complications after elective laparoscopic cholecystectomy for biliary disease.

Methods

Fifty-seven patients older than 65 years who were to undergo elective laparoscopic cholecystectomy for uncomplicated biliary disease were prospectively examined. Preoperative CGA was performed and the patients were categorized as fit or frail. The main outcome of the study was the rate of any postoperative complication within 30 days of surgery.

Results

There were 29 women (50.9 %) and the median (interquartile range) age of the cohort was 73 (8.8) years. Thirty-two patients (56.1 %) were categorized as frail and 25 (43.9 %) as fit. The overall incidence of postoperative complications was 23.7 %, most of which were grade I and II (18.8 %). Frail patients, according to the CGA assessment, experienced a significantly higher incidence of postoperative complications compared to their fit counterparts (84.6 vs. 15.4 %, p = 0.023). Frail patients experienced a significantly higher frequency of prolonged (more than 2 days) postoperative hospital stay compared with their fit counterparts (p = 0.023).

Conclusions

Preoperative CGA may predict postoperative complications and prolonged postoperative hospital stay of elderly patients who undergo elective laparoscopic cholecystectomy. Larger-scale studies independently assessing this association are warranted.

Keywords

Frailty Comprehensive geriatric assessment Laparoscopic cholecystectomy Postoperative complications 

Notes

Disclosures

Drs. K. Lasithiotakis, J. Petrakis, M. Venianaki, G. Georgiades, D. Koutsomanolis, A. Andreou, O. Zoras, and G. Chalkiadakis have no conflicts of interest or financial ties to disclose.

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Copyright information

© Springer Science+Business Media, LLC 2012

Authors and Affiliations

  • Konstantinos Lasithiotakis
    • 1
    Email author
  • John Petrakis
    • 1
  • Maria Venianaki
    • 1
  • George Georgiades
    • 1
  • Dimosthenis Koutsomanolis
    • 1
  • Alexander Andreou
    • 1
  • Odysseas Zoras
    • 1
  • George Chalkiadakis
    • 1
  1. 1.Department of General SurgeryHeraklion University HospitalHeraklionGreece

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