Outcomes of elective and urgent laparoscopic cholecystectomy in the over eighties

Abstract

Background: Over eighties usually undergo laparoscopic cholecystectomy in urgency. Indeed over
eighties aren’t usually operated in election for cholelithiasis, even when already symptomatic for colic
without fever. The aim of this study is to understand the differences between the elective and urgent
setting and if the current approach is appropriate.

Materials and methods: We consider 41 patients who underwent laparoscopic cholecystectomy
between 2013 and 2016 at Chiari Hospital. The mean age was 83. 26 patients were female whereas
15 male. 18 patients underwent elective surgery whereas 23 urgent laparoscopic cholecystectomy.
There are no significat differences in comorbidities between the two groups. For every patient we have
considered conversion to open surgery, length of hospital stay, post-operative morbidity.

Results: Mortality rate was null. No case of conversion to open surgery was recorded in the elective
setting, whereas 8,7% (2/23) of urgent laparoscopic cholecystectomies were converted. The mean length
of hospital stay was 2 days in the elective group versus 6 days in the urgent group. No post-operative
complications were recorded after elective surgery, whereas rate of post-operative morbidity was 17,4%
after urgent cholecystectomy.

Conclusions: Laparoscopic cholecystectomy in the over eighty is a safe procedure with acceptable
morbidity even for multi-pathological patients in an urgent setting.
The good outcomes of the elective surgery should induce surgeons to operate over eighties in election
even when there are few symptoms, preventing morbidity associated to urgent intervention.