Outcomes of laparoscopic cholecystectomy for acute and chronic cholecystitis in elderly patients: Preliminary results

Abstract

Introduction: Laparoscopic cholecystectomy (LC) is the standard therapy for cholecystolithiasis. LC is considered a very safe intervention with occasional complications. However in elderly patients the presence of comorbidities may increase the risk of complications especially in cases of acute cholecystitis. In this study we aimed to compare LC outcome for acute (CCA) and chronic (CCC) cholecystitis in patients over 60 years. Methods: We retrospectively evaluated 138 patients over 60 years old that were submitted to LC for cholecystolithiasis. We analyzed age, sex, BMI, ASA, cardiac risk (CR), length of hospital stay, comorbidities and postoperative complications. Results: There were no differences in age, sex, BMI, ASA classification and cardiac risk between groups. The mean of comorbidities per patient was increased in CCA compared to CCC group (p = 0.028). The length of postoperative hospital stay was 4.72±4.18 days in CCA and 2.49±3.54 days in CCC group (p < 0.0001). The mean of complications for patient was higher in the CCA group (p = 0.0077), and 33% of patients with CCA presented complications compared to 12% with CCC (p < 0.0001). Near 6% of patients died in the CCA and less than 1% in the CCC group, without statistical significance. Conclusion: This study demonstrated that elective LC is a safe procedure in aged patients with chronic cholecystolithiasis. However patients with acute disease have increased incidence of postoperative complications with prolonged postoperative hospital stay that may be related to the increased incidence of comorbidities.