Page 22 - WJOLS - Surgery Journal

World Journal of Laparoscopic Surgery, January-April 2009;2(1):23-26
Laparoscopic Cholecystectomy is Safe in the Elderly Patients

Laparoscopic Cholecystectomy is Safe in the

Elderly Patients

Mohend AN Alshalah
Department of Surgery, College of Medicine, Babylon University, Babylon, Iraq

17
Abstract who represent the fastest growing segment. Although they
Background: The aim of this review was to evaluate the rate of currently comprise only one-eighth of the population, the elderly
laparoscopic surgery in elderly patients with gallstones and to compare already account for nearly one-third of surgical patients.
it with their younger counterparts, also to study the safety and efficacy Cholecystectomy is the most commonly performed surgical
of laparoscopic cholecystectomy in elderly patients by comparing the procedure in elderly individuals. Life expectancy has been
15
results with open cholecystectomy (OC). progressively increasing during the past few decades.
The relation between ages, comorbid diseases, mean operative Improvements in primary prevention, advances in acute
time, hospital stay, the incidence of major postoperative complications
and the rate of conversion were also evaluated. medical care, and progress in pharmaceutical and biomedical
17
technology may be the cause for that demographic change.

Content: Twenty studies evaluated laparoscopic cholecystectomy in The term ‘elderly’ is used in the medical literature to describe

the elderly. Compared with open cholecystectomy, elderly patients

undergoing the laparoscopic procedure had a lower incidence of people older than 65 years. With an increasing life expectancy

complications and a shorter hospitalization. Advanced age with its of more than 65 years, it is becoming harder to define the real
concomitant comorbid conditions may be associated with increased ‘old’ and therefore ‘high-risk’ group of patients from the
postoperative laparoscopic cholecystectomy (LC) complications and viewpoint of modern medicine. 17
more frequent conversion to open cholecystectomy (OC). The advances in minimally invasive surgery over the past
Material and methods: An electronic search using the Midline and the decade have benefited patients undergoing a variety of surgical
search engine Google, Springer link and Highwire press databases was procedures. For the elderly, who often are less able to withstand

performed using the term laparoscopy cholecystectomy in elderly the trauma and stress of open abdominal surgery, the

patients. Literature published in the English languagein the past 9 years advantages of a laparoscopic approach may be especially
was reviewed. Relevant surgical textbooks were also reviewed. important. 16
Methods literature searches were conducted to identify: (1) comparative (LC) is now the gold standard treatment of symptomatic
studies which reported (LC) outcomes in elderly Compared with open gallstones and is the commonest operation performed laparo-

cholecystectomy and; (2) Studies comparing outcomes of (LC)in elderly scopically world-wide. 8
with their younger age group (3) Also comparing the outcome of Our aim was to evaluate the rate of laparoscopic surgery in
elderly patients presented electively and urgently. elderly patients with gallstones and to compare it with their

Conclusions: Underlying cardiopulmonary diseases, individualsolder younger counterparts. The relation between age and the rate of
than 65 years tolerate laparoscopic cholecystectomy well. Post- conversion, risk factors associated with prolonged post-
operative complications and hospitalization are lower than in open operative hospitalization were also evaluated, and comparing
cholecystectomy. Laparoscopic cholecystectomy is a safe procedure with the results of (OC).
in gall bladder diseases.
Laparoscopic cholecystectomy is a safe procedure for acute MATERIAL AND METHODS
Cholecystitis in elderly patients, resulting in fewer complications and
shorter hospital stay than open cholecystectomy. Emergency LC A literature search was performed using the Midline and the
surgery in elderly patients have higher rate of morbidity and mortality search engine Google, Springer link and Highwire press
but less than in OC. databases was performed using the term laparoscopy in elderly
patients. Literature published in the English language in the
Keywords: Laparoscopic cholecystectomy, open cholecystectomy, past 10 years was reviewed. Relevant surgical textbooks were
elderly, safe.
also reviewed.
965 citation found in total, selected papers were screened
INTRODUCTION
for further references.
As our population ages, outcomes analysis of surgical treatment Criteria for selection of literatures were the number of cases
strategies become increasingly important in elderly patients (excluded if less than 20), method of analysis (statistical or non-

23