Hepato-biliary disease in the elderly.

Abstract

It was reported that there were high morbidity and mortality associated with ageing. During the five year period from Jan. 1981 to Dec. 1985, 1,222 patients were admitted to KMCH, Department of Surgery, for treatment of hepato-biliary disease. Two hundred and thirty five (19.2%) patients were 65 or older and 987 (80.8%) patients were younger than 65. The mortality rate (MR) was 17.4% in the aged group vs 7.6% in the younger group (p＜0.0001). In gallstone disease, the MR was significantly higher in the aged group (10.5% vs 4.6%) (p＜0.01). In location distribution, gallbladder with common bile duct stone and common bile duct stone only were predominant in the aged (19.1% vs 7.1%, 23% vs 14.1%) (p＜0.001, p＜0.01). The incidence of gallstone disease with malignancy in the aged group was 7.2% vs 4.7% in the younger group. In malignant hepato-biliary disease, the MR was significantly higher in the aged (19.3% vs 16.7%) (p＜0.01). Concerning the distribution of malignancy, periampullar carcinoma was higher in the aged (46.1% vs 25.8%) (p＜0.001), and the incidence of malignancy combined with gallstone was around 11.5%. In regard to the cause of mortality cases of gallstone disease, sepsis and hepatic failure were predominant in all ages, heart failure was the third leading cause in aged patients. In malignant hepato-biliary disease, hepatic failure was obviously the main cause of death in both age groups.