Skip to main content

Advertisement

Log in

Laparoscopic Cholecystectomy in Patients Aged 80 Years and Over

  • ORIGINAL SCIENTIFIC REPORTS
  • Published:
World Journal of Surgery Aims and scope Submit manuscript

Abstract

Introduction

The aging population has led to a significant rise in the number of patients undergoing operations such as cholecystectomy. We have evaluated and compared the results of laparoscopic cholecystectomy (LC) in patients aged 80 years and over with those of patients aged between 65 and 79 years.

Methods

A total of 471 patients aged 65 to 79 years (group 1) and 45 patients aged ≥80 years (group 2) underwent LC. All patients underwent preoperative spiral computed tomography after intravenous infusion cholangiography and intraoperative cholangiography.

Results

There was a higher incidence of choledocholithiasis and gallbladder cancer in the patients ≥80 years of age. In addition, group 2 patients had a higher incidence of cardiopulmonary disease and higher American Association of Anesthesiology scores than did those in group 1. With respect to the conversion rate to open surgery, morbidity, mortality, and length of hospital stay, there were no significant differences between the two groups. There was a significantly higher incidence of positive bile cultures and gram-negative rods in group 2 patients than in those in group 1.

Conclusions

Octogenarians tolerated LC well. Therefore, early elective LC should be encouraged to minimize morbidity and mortality in these elderly patients who have symptomatic cholelithiasis.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. National Institute of Population and Social Security Research. Population Projections for Japan: 2001–2050. Tokyo, NIPSSR, 2002;1–29. http://www.ipss.go.jp/index-e. html

  2. Bennion LJ, Grundy SM. Risk factors for the development of cholelithiasis in man. N Engl J Med 1979;299:1221–1227

    Article  Google Scholar 

  3. Bufalari A, Cao MF, Cirocchi R, et al. Surgical care in octogenarians. Br J Surg 1996;83:1783–1787

    PubMed  CAS  Google Scholar 

  4. Sandler RS, Maule WF, Baltus ME, et al. Biliary tract surgery in the elderly. J Gen Intern Med 1987;2:149–154

    PubMed  CAS  Google Scholar 

  5. Huber DF, Martin EW, Cooperman M. Cholecystectomy in elderly patients. Am J Surg 1983;146:719–721

    Article  PubMed  CAS  Google Scholar 

  6. Lujan JA, Sanchez-Bueno F, Parrilla P, et al. Laparoscopic vs open cholecystectomy in patients aged 65 and older. Surg Laparosc Endosc 1998;8:208–210

    Article  PubMed  CAS  Google Scholar 

  7. Fried GM, Clas D, Meakins JL. Minimally invasive surgery in the elderly patient. Surg Clin North Am 1994;74:375–387

    PubMed  CAS  Google Scholar 

  8. Magnuson TH, Ratner LE. Zenilman ME. Laparoscopic cholecystectomy: applicability in the geriatric population. Am Surg 1997;117:156–164

    Google Scholar 

  9. Kwon AH, Uetsuji S, Yamada O, et al. Three-dimensional reconstruction of the biliary tract using spiral computed tomography. Br J Surg 1995;82:260–263

    PubMed  CAS  Google Scholar 

  10. Kwon AH, Uetsuji S, Ogura T, et al. Spiral computed tomography scanning after intravenous infusion cholangiography for biliary duct anomalies. Am J Surg 1997;174:396–401

    PubMed  CAS  Google Scholar 

  11. American Joint Committee on Cancer. AJCC Cancer Staging Manual, 5th edition. Lippincott-Raven, Philadelphia, 1997;103–105

    Google Scholar 

  12. Brunt LM, Quasebarth DL, Dunnegan DL, et al. Outcomes analysis of laparoscopic cholecystectomy in the extremely elderly. Surg Endosc 2001;15:700–705

    Article  PubMed  CAS  Google Scholar 

  13. Shamburek RD, Farrar JT. Disorders of the digestive system in the elderly. N Engl J Med 1990;322:438–443

    Article  PubMed  CAS  Google Scholar 

  14. Kahng KU, Roslyn JJ. Surgical issues for the elderly patient with hepatobiliary disease. Surg Clin North Am 1994;74:345–373

    PubMed  CAS  Google Scholar 

  15. Rege RV. Asymptomatic gallstones. In: Cameron JL, editor, Current Surgical Therapy, 6th edition. St. Louis, Mosby–Year Book, 1998;403–405

    Google Scholar 

  16. Harness JK, Strodel WE, Talsma SE. Symptomatic biliary tract disease in the elderly patient. Am Surg 1986;52:442–445

    PubMed  CAS  Google Scholar 

  17. Firilas A, Duke BE, Max MH. Laparoscopic cholecystectomy in the elderly. Surg Endosc 1996;10:33–35

    Article  PubMed  CAS  Google Scholar 

  18. Behrman SW, Melvin WS, Babb ME, et al. Laparoscopic cholecystectomy in the geriatric population. Am Surg 1996;62:386–390

    PubMed  CAS  Google Scholar 

  19. Pessaux P, Tuech JJ, Derouet N, et al. Laparoscopic cholecystectomy in the elderly: a prospective study. Surg Endosc 2000;14:1067–1069

    PubMed  CAS  Google Scholar 

  20. Tagle FM, Lavergne J, Barkin JS, et al. Laparoscopic cholecystectomy in the elderly. Surg Endosc 1997;11:636–638

    Article  PubMed  CAS  Google Scholar 

  21. Askew AR. Surgery for gallstones in the elderly. Aust N Z J Surg 1995;65:312–315

    PubMed  CAS  Google Scholar 

  22. Maxwell JG, Tyler BA, Maxwell BG, et al. Laparoscopic cholecystectomy in octogenarians. Am Surg 1998;64:826–832

    PubMed  CAS  Google Scholar 

  23. Kwon AH, Matsui Y, Uemura Y. Surgical procedures and histopathologic findings for patients with xanthogranulomatous cholecystitis. J Am Coll Surg 2004;199:204–210

    Article  PubMed  Google Scholar 

  24. Tomikawa M, Kitano S, Iso Y, et al. Feasibility of laparoscopic cholecystectomy for patients with a nonvisualized gallbladder on drip infusion cholangiography. Surg Laparosc Endosc 1995;5:121–124

    PubMed  CAS  Google Scholar 

  25. Kwon AH, Inui H, Imamura A, et al. Preoperative assessment for laparoscopic cholecystectomy: feasibility of using spiral computed tomography. Ann Surg 1998;227:351–356

    Article  PubMed  CAS  Google Scholar 

  26. Uecker J, Adams M, Skipper K, et al. Cholecystitis in the octogenarian: is laparoscopic cholecystectomy the best approach? Am Surg 2001;67:637–640

    PubMed  CAS  Google Scholar 

  27. Maxwell JG, Tyler BA, Rutledge R, et al. Cholecystectomy in patients aged 80 and older. Am J Surg 1998;176:627–631

    Article  PubMed  CAS  Google Scholar 

  28. Laycock WS, Siewers AE, Birkmeyer CM, et al. Variation in the use of laparoscopic cholecystectomy for elderly patients with acute cholecystitis. Arch Surg 2000;135:457–462

    Article  PubMed  CAS  Google Scholar 

  29. Weber DM. Laparoscopic surgery: an excellent approach in elderly patients. Arch Surg 2003;138:1083–1088

    Article  PubMed  Google Scholar 

  30. Krarup T, Sønderstrup J, Kruse-Blinkenberg HO, et al. Surgery for gallstones in old age: do we operate too late? Acta Chir Scand 1982;148:263–266

    PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to A-Hon Kwon MD.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Kwon, AH., Matsui, Y. Laparoscopic Cholecystectomy in Patients Aged 80 Years and Over. World J. Surg. 30, 1204–1210 (2006). https://doi.org/10.1007/s00268-005-0413-2

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00268-005-0413-2

Keywords

Navigation