Turkish Journal of Geriatrics 2015 , Vol 18, Issue 2
Burhan MAYIR1, Cemal Ozben ENSARİ1, Mehmet Tahir ORUC1, Uğur DOĞAN1, Bulent DİNC2, Tuğrul CAKIR1, Arif ASLANER1, Bilge BAŞ2
1Antalya Training and Research Hospital, General Surgery Clinic, ANTALYA
2Antalya Atatürk State Hospital, General Surgery Clinic, ANTALYA
Introduction: Postoperative morbidity and mortality are more frequent among older patients due to reasons such as decreased organ function and accompanying disorders and malnutrition. Laparoscopic interventions in the elderly patients can also contribute to morbidity and mortality. The purpose of this study was to assess the safety of laparoscopic cholecystectomy in the aged and very aged patients.

Materials and Method: The patients were divided into three groups based on age. Groups 1, 2 and 3 comprised patients aged <65, 65–79 and ≥80 years, respectively. Each group included 50 consecutive patients who had undergone laparoscopic cholecystectomy.

Results: The groups were different from each other in terms of pre-operation albumin level, American Society of Anesthesiologist (ASA) score, existence of hypertension, coronary artery disease and chronic obstructive lung disease, duration of the operation, emergency operation ratio, morbidity rates. Morbidity was observed in 13 (8.7%) patients, with pulmonary complications in six, cardiac complications in five and infectious complications in two. There was no mortality in the study groups. The rate of morbidity was significantly higher in patients aged>80 years than other patients. Incidence of coronary artery disease, chronic obstructive pulmonary disease, low hemoglobin and albumin levels and high ASA score occurred more frequently in patients with morbidity. Logistic regression analysis showed that presence of chronic obstructive pulmonary disease and low albumin levels was associated with morbidity.

Conclusion: In the very aged patients, for whom cholecystectomy has been planned, laparoscopic cholecystectomy can be performed safely. However, laparoscopic cholecystectomy should be performed only after thorough patient evaluation and presurgical preparation because the most important factors associated with morbidity and mortality are co-existing disorders and nutritional status. Keywords : Geriatrics; Cholecystectomy, Laparoscopic; Morbidity