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Journal of Gastroenterology

, Volume 47, Issue 1, pp 65–70 | Cite as

Is cholecystectomy necessary after endoscopic treatment of bile duct stones in patients older than 80 years of age?

  • Takaharu Yasui
  • Shunichi Takahata
  • Hiroshi Kono
  • Yosuke Nagayoshi
  • Yasuhisa Mori
  • Kosuke Tsutsumi
  • Yoshihiko Sadakari
  • Takao Ohtsuka
  • Masafumi Nakamura
  • Masao Tanaka
Original Article—Liver, Pancreas, and Biliary Tract

Abstract

Background and aims

Although patients with cholecystocholedocholithiasis are generally referred to cholecystectomy after endoscopic sphincterotomy (ES) and common bile duct clearance, we often have a conflict whether cholecystectomy is necessary in very elderly patients with comorbid diseases. The aim of this study is to assess whether cholecystectomy in very elderly patients is justified after ES.

Patients and methods

Patients with cholecystocholedocholithiasis who underwent ES and stone extraction and were followed-up for more than 10 years were retrospectively reviewed. We divided these patients into two groups: the elderly group (equal to or more than 80 years old) and young group (less than 80 years old) and compared late biliary complications and mortality.

Results

The 10-year cumulative incidence of overall biliary complications was significantly lower in cholecystectomized patients than in patients with gallbladder in situ in the young group (7.5 vs. 21.7%, p = 0.0037), but not different in the elderly group (8.3 vs. 7.4%, p = 0.92). When each complication was evaluated separately, the rate of recurrent common bile duct stones (CBDS) was not different, but that of acute cholecystitis was significantly lower in the elderly group than in the young group (4.1 vs. 22.6%, p = 0.011).

Conclusions

In very elderly patients the incidence of acute cholecystitis is low even when the gallbladder is preserved after endoscopic treatment of CBDS, with a similar risk of CBDS recurrence. Thus, it may not be necessary to recommend cholecystectomy after ES for CBDS in very elderly patients.

Keywords

Common bile duct stone Gallbladder stone Endoscopic sphincterotomy Elderly Cholecystectomy 

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Copyright information

© Springer 2011

Authors and Affiliations

  • Takaharu Yasui
    • 1
  • Shunichi Takahata
    • 1
  • Hiroshi Kono
    • 1
  • Yosuke Nagayoshi
    • 1
  • Yasuhisa Mori
    • 1
  • Kosuke Tsutsumi
    • 1
  • Yoshihiko Sadakari
    • 1
  • Takao Ohtsuka
    • 1
  • Masafumi Nakamura
    • 1
  • Masao Tanaka
    • 1
  1. 1.Department of Surgery and Oncology, Graduate School of Medical SciencesKyushu UniversityFukuokaJapan

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