Laparoscopic cholecystectomy in elderly patients: Avoid or expedite? - A comparative cohort study
Introduction: Although laparoscopic cholecystectomy (LC) has become the gold standard for treating gall bladder stones (GBS), its safety in elderly patients is still questioned. This study aimed to assess the outcome of LC in patients 70 and older compared to younger patients. Patients and Methods:...
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2025-07-01
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| Series: | Journal of Minimal Access Surgery |
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| Online Access: | https://journals.lww.com/10.4103/jmas.jmas_138_24 |
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| author | Maria Mondragon Ali Yasen Mohamedahmed Shafquat Zaman Ja’quay Farquharson Usman Raja Arhum Ijaz Deepak Singh-Ranger |
| author_facet | Maria Mondragon Ali Yasen Mohamedahmed Shafquat Zaman Ja’quay Farquharson Usman Raja Arhum Ijaz Deepak Singh-Ranger |
| author_sort | Maria Mondragon |
| collection | DOAJ |
| description | Introduction:
Although laparoscopic cholecystectomy (LC) has become the gold standard for treating gall bladder stones (GBS), its safety in elderly patients is still questioned. This study aimed to assess the outcome of LC in patients 70 and older compared to younger patients.
Patients and Methods:
The medical records of 548 patients undergoing LC were evaluated retrospectively. Patients’ demographics and post-operative complications were recorded. Furthermore, patients were divided according to the CEPOD into emergency and elective patients, and complications were recorded according to Clavien–Dindo (CD) classifications. Data analysis was performed with SPSS software version 27.
Results:
Patients were divided into the elderly patients group (≥70 years of age, n = 185) and the young patients group (<70 years of age, n = 363). The ≥70-year-old group showed a significantly higher number of patients who required emergency admission with GBS symptoms (P = 0.001), emergency LC (P = 0.01) and conversion to open (P = 0.02). The two groups showed comparable post-operative complications: bile leak (P = 0.26), collection (P = 0.11) and re-operation (P = 0.60), post-operative endoscopic retrograde cholangiopancreatography (P = 1.0), GBS pancreatitis (P = 0.33) and death (0.30). CD I–II complications were higher in the ≥ 70-year-old group compared to the <70-year-old group in elective (P = 0.01) and emergency (P = 0.03) LC. However, CD ≥3 complications were higher in the ≥70-year-old group than the <70-year-old group in the emergency LC (P = 0.01) and comparable in the elective LC (P = 0.12).
Conclusion:
LC is safe and efficient in elderly patients. Elective LC should be expedited in elderly patients to avoid emergency admissions and emergency LC, which are associated with higher complication rates. |
| format | Article |
| id | doaj-art-119dabf04ad64374ac09aed7aba0f74a |
| institution | Kabale University |
| issn | 0972-9941 1998-3921 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Journal of Minimal Access Surgery |
| spelling | doaj-art-119dabf04ad64374ac09aed7aba0f74a2025-08-20T03:41:57ZengWolters Kluwer Medknow PublicationsJournal of Minimal Access Surgery0972-99411998-39212025-07-0121326526910.4103/jmas.jmas_138_24Laparoscopic cholecystectomy in elderly patients: Avoid or expedite? - A comparative cohort studyMaria MondragonAli Yasen MohamedahmedShafquat ZamanJa’quay FarquharsonUsman RajaArhum IjazDeepak Singh-RangerIntroduction: Although laparoscopic cholecystectomy (LC) has become the gold standard for treating gall bladder stones (GBS), its safety in elderly patients is still questioned. This study aimed to assess the outcome of LC in patients 70 and older compared to younger patients. Patients and Methods: The medical records of 548 patients undergoing LC were evaluated retrospectively. Patients’ demographics and post-operative complications were recorded. Furthermore, patients were divided according to the CEPOD into emergency and elective patients, and complications were recorded according to Clavien–Dindo (CD) classifications. Data analysis was performed with SPSS software version 27. Results: Patients were divided into the elderly patients group (≥70 years of age, n = 185) and the young patients group (<70 years of age, n = 363). The ≥70-year-old group showed a significantly higher number of patients who required emergency admission with GBS symptoms (P = 0.001), emergency LC (P = 0.01) and conversion to open (P = 0.02). The two groups showed comparable post-operative complications: bile leak (P = 0.26), collection (P = 0.11) and re-operation (P = 0.60), post-operative endoscopic retrograde cholangiopancreatography (P = 1.0), GBS pancreatitis (P = 0.33) and death (0.30). CD I–II complications were higher in the ≥ 70-year-old group compared to the <70-year-old group in elective (P = 0.01) and emergency (P = 0.03) LC. However, CD ≥3 complications were higher in the ≥70-year-old group than the <70-year-old group in the emergency LC (P = 0.01) and comparable in the elective LC (P = 0.12). Conclusion: LC is safe and efficient in elderly patients. Elective LC should be expedited in elderly patients to avoid emergency admissions and emergency LC, which are associated with higher complication rates.https://journals.lww.com/10.4103/jmas.jmas_138_24elderly patientsgall bladder stoneslaparoscopic cholecystectomy |
| spellingShingle | Maria Mondragon Ali Yasen Mohamedahmed Shafquat Zaman Ja’quay Farquharson Usman Raja Arhum Ijaz Deepak Singh-Ranger Laparoscopic cholecystectomy in elderly patients: Avoid or expedite? - A comparative cohort study Journal of Minimal Access Surgery elderly patients gall bladder stones laparoscopic cholecystectomy |
| title | Laparoscopic cholecystectomy in elderly patients: Avoid or expedite? - A comparative cohort study |
| title_full | Laparoscopic cholecystectomy in elderly patients: Avoid or expedite? - A comparative cohort study |
| title_fullStr | Laparoscopic cholecystectomy in elderly patients: Avoid or expedite? - A comparative cohort study |
| title_full_unstemmed | Laparoscopic cholecystectomy in elderly patients: Avoid or expedite? - A comparative cohort study |
| title_short | Laparoscopic cholecystectomy in elderly patients: Avoid or expedite? - A comparative cohort study |
| title_sort | laparoscopic cholecystectomy in elderly patients avoid or expedite a comparative cohort study |
| topic | elderly patients gall bladder stones laparoscopic cholecystectomy |
| url | https://journals.lww.com/10.4103/jmas.jmas_138_24 |
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