LAPAROSCOPIC CHOLECYSTECTOMY IN THE ELDER LY

Biliary surgery in the elderly is associated with a high morbidity and mortality rate. The aim of this prospective study is to determine the complications or benefits of laparoscopic cholecystectomy in patients over 75. From December 1989 to July 1992, 60 women and 15 men, all ag ed over 75, underwent laparoscopic cholecystectomy. 32 (43%) were at h igh surgical half of cases, complications were present (30 cases of ac ute cholecystitis and 13 cases of choledocolithiasis). 10 underwent en doscopic sphincterotomy preoperatively and 4 patients with common bile duct stones were treated by laparoscopy during the same operating tim e. Eight conversions were necessary because of inflammatory process. T he global morbidity rate was 10.6%. Local complications were: 1 wound abscess, 1 wound dehiscence, 2 biliary leaks and 2 cases of bleeding a t puncture sites. The general complications concerned the respiratory tract except for one case of urinary tract infection. The mortality ra te was zero. Laparoscopic cholecystectomy seems to be better tolerated than laparotomy. It allows curative treatment of gallstones, complica ted or not, with a low morbidity rate.