Advanced Jaundice Research Articles

Biliary Tract Surgery in the Aged Patient

Summary An analysis was made of a group of 77 patients, all over the age of 65, who were operated upon for some form of biliary tract disease. All but 2 of these patients had gallstones; 15.6 per cent had pathologically verified acute cholecystitis; 20.8 per cent had choledocholithiasis. The surgical mortality for the whole group was 7.7 per cent (6 cases). All but 1 of these deaths occurred in patients with advanced jaundice at the time of surgery. No deaths occurred in the group with acute cholecystitis. The remaining death and the only one that occurred in the patients who had undergone elective cholecystectomy was due to delayed hemorrhage and was attributed to poor surgical technique. Thus, in our experience jaundice was a grave complication of calculous cholecystitis and indicated a poor prognosis. The policy of regarding all calculous cholecystitis, whether symptomatic or not, as a potential hazard to life and an indication for elective cholecystectomy seems justified.