Laparoscopic Cholecystectomy in Octogenerians: Outcome Analysis of 48 Consecutive Cases by a Single Surgeon

R A Gamagami, MD, Paul Kozak, Natalia Sopiarz

Department of Surgery; Silver Cross Hospital, New Lenox, Illinois

Background: The aging population has led to an increase in the number of patients undergoing laparoscopic cholecystectomy (LC). Wide variations are reported in morbidity, mortality, and conversion rates involving multiple surgeons. Previous data have shown that the morbidity ranged from 14-18%, mortality ranged from 0-8.6%, and conversion rates were 2-37%. We retrospectively assessed whether a reduction in adverse outcome can be obtained by an experienced single surgeon at one institution.

Method: All consecutive patients 80 years and older who underwent LC for symptomatic gallbladder disease over a 5 year period were retrospectively analyzed. Data analysis included patiets’ age, gender, comorbid condition, American Society of Anesthesiology (ASA) score, operative time, conversion to open, morbidity, mortality, and length of stay.

Results: In this study, 48 patients (mean age 84 years [range 80-94], 29 females) were evaluated. A total of 35 patients (73%) had a preoperative ASA score of 3 or 4. The mean operative time was 46 + 17 minutes. No patient was converted to open. Minor complications occurred in 6 patients (8.3%), including hypoxemia, atrial fibrillation, atelectasis. There was no mortality. There were 20 patients (42%) who required inpatient hospitalization with a mean length of stay of 3.25 days.

Conclusion: A reduction in morbidity, mortality, and conversion rates can be achieved in the octogenarians undergoing laparoscopic cholecystectomy by an experienced laparoscopic surgeon.


Session: Poster Presentation

Program Number: P316

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