Laparoscopic Cholecystectomy in Patients Over 80 Years is Feasible and Safe: Analysis of 68 Consecutive Cases

Abstract

Background: Wide variations are reported in morbidity, mortality and conversion rates for laparoscopic cholecystectomy in the octogenarian population. As a retrospective review, this paper reports the experience of a district general hospital unit in the management of gallstone disease in an elderly population. Methods: The case notes of all patients over 80 years of age undergoing laparoscopic cholecystectomy over a 7 years period were retrospectively analyzed. Primary outcome measures were conversion to an open procedure and complications of surgery. Results: Sixty-eight octogenarians (mean age of 84 years [range 8096 years], 37 female) undergoing laparoscopic cholecystectomy were identified. Five (7.3%) operations were converted to open surgery. The total number of patients having complications was 16 (24%), 8 (12%) being grade 1 and 8 (12%) grade 2. Forty-eight (71%) patients had complicated gallstone disease. Grade 2 complications were related to the presence of CBD stones (p = 0.0003). Conclusion: Octogenarians should be considered for laparoscopic cholecystectomy for symptomatic gallstones. Although the overall risk of complications remains higher in octogenarians, conversion rates can be low. Octogenarians with common bile duct stones may be best managed with ERCP as this group of patients appears to be at particular risk from surgical intervention.