D. Lucidarme et al., RESULTS OF LAPAROSCOPIC CHOLECYSTECTOMY F OR ACUTE CHOLECYSTITIS IN ELDERLY PATIENTS, Journal de chirurgie, 134(7-8), 1997, pp. 291-295
Objectives : The aim of this retrospective study was to evaluate the f
easibility and the morbidity of laparoscopic cholecystectomy for acute
cholecystitis in elderly patients. Methods : Among 891 consecutive pa
tients who underwent cholecystectmy, 151 had acute cholecystitis. Fift
y three patients of greater than or equal to 70 years of age (group 1)
were compared to 98 younger patients (group 2). Analysis was made in
''intention to treat'' so directly open cholecystectomies during the s
ame period were also included. Results : Elderly patients had a lower
success rate of laparoscopic treatment (52.8 % versus 70.4 %; p < 0.05
). This difference was due to higher rate of directly open cholecystec
tomy in the elderly (17 % versus 2 %). There was no difference between
both groups in conversion rate to laparotomy (30.2 % versus 26.5 %).
Surgical morbidity was 7.5 % in group 1 and 4 % in group 2 (NS). Gener
al complications were more frequent in the elderly (p < 0.05). Five pa
tients in group 1 (9.4 %) died of general complications of which 3 wer
e operated on directly by open cholecystectomy. There was no mortality
in group 2. Conclusion :Acute cholecystitis in the elderly remains a
severe disease in which laparoscopic treatment is only possible in abo
ut fifty percent.