COMPARISON OF MORTALITY-RATES FOR OPEN AND CLOSED CHOLECYSTECTOMY IN THE ELDERLY - CONNECTICUT STATEWIDE SURVEY

The objective was to determine the safety of laparoscopic cholecystect omy for patients 65 years of age and older with symptomatic uncomplica ted chronic gallbladder disease by comparing the mortality rate with o pen cholecystectomy. Connecticut Hospital Information Management Excha nge and Connecticut Society of American Board of Surgeons established a Connecticut Laparoscopic Registry made up of 33 acute care hospitals . A cohort longitudinal retrospective statewide registry collected dat a mortality rates on all 2865 elderly patients undergoing open (OC) or closed (LC) cholecystectomy for uncomplicated chronic cholecystitis. A database was established and continuously monitored from October 1, 1988, to December 31, 1992. Seven hundred sixty-one patients over 65 y ears of age underwent open cholecystectomy for uncomplicated chronic c holecystectomy during fiscal year 1989, with a mortality rate of 1.4%. The mortality rate of a similar cohort of patients who underwent lapa roscopic cholecystectomy during fiscal years 1991 and 1992 was 0.3% an d 0.6%, respectively. The mortality rate was further broken down into age subsets 65-69, 70-79, and 80+. the prelaparoscopic era (FY 1989) a ge subsets were compared with those of the laparoscopic era (FY 1991 a nd 1992). A statistically significant reduction (p = 0.01) in mortalit y rate was noted in the 70-79 age group following laparoscopic surgery . Laparoscopic cholecystectomy in the elderly for the treatment of sym ptomatic, uncomplicated chronic cholecystitis is as safe if not safer than open cholecystectomy as measured by mortality rate.