PULMONARY-FUNCTION AFTER LAPAROSCOPIC CHOLECYSTECTOMY IN THE ELDERLY

The results of laparoscopic cholecystectomy in a group of 52 patients older than 69 years (group 1) were compared with the results of the sa me operation in a group of 338 younger patients (group 2). In group 1, 23 per cent of patients had acute cholecystitis and 13 per cent were operated on after an episode of acute pancreatitis. In group 2, 8 per cent of patients had acute cholecystitis and 4 per cent were operated on after acute pancreatitis. Pulmonary function was assessed prospecti vely before operation, 24 h after surgery and on the seventh day after operation, in 20 patients in group 1 and 30 in group 2. In group 1 th ere was one death (2 per cent); the morbidity rate was 14 per cent and conversion to laparotomy was required in 15 per cent. In group 2 ther e were no deaths, the morbidity rate was 11 per cent and the conversio n rate 4 per cent. No significant differences were found between the t wo groups in mortality and morbidity rates. Preoperative values of for ced vital capacity (FITC) and forced expiratory volume in Is (FEV(1)) were significantly lower in group 1 than in group 2 (P<0.05); the valu es of FVC, FEV(1) and forced expiratory how at 50 per cent 24 h after surgery were less depressed in group 1 (P<0.01) and also recovered mor e quickly in these patients 7 days after operation. Laparoscopic chole cystectomy gives excellent results in geriatric patients and can be re commended as the treatment of choice for symptomatic cholelithiasis in the elderly.