INCIDENTAL CHOLECYSTECTOMY IN THE OVER-70 AGE GROUP - A 19-YEAR RETROSPECTIVE, COMPARATIVE-STUDY

Objectives. To analyse the outcome of incidental cholecystectomy in th e over 70 age-group during surgery for gastrointestinal malignancies, Design, Nineteen-year retrospective, comparative study, Setting, Depar tment of Surgery B, Belinson Campus, Rabin Medical Center, Subjects, T he hospitalization records of 4,072 patients who underwent cholecystec tomy between 1975 and 1994 were reviewed, The incidental cholecystecto my cases for this period were identified and those performed during su rgery for gastrointestinal malignancy were analysed separately, A sex- and age-matched control group was identified for comparison, Main out come measures, Postoperative complications, overall morbidity and mort ality, postoperative hospitalization days, Statistical differences in gallbladder-related complications and mortality among groups, Results, Mortality and overall morbidity were significantly increased in the n o-cholecystectomy group, Hospitalization days were increased significa ntly in the group not undergoing cholecystectomy and although it didn' t reach statistical significance, there was a clear trend for increase d number of pulmonary complication in this same group, Sepsis and mult iorgan failure, as an expression of acutely, postoperative symptomatic gallbladder were the major cause of death in the no-incidental-cholec ystectomy group. Conclusions, Incidental cholecystectomy Is safe and s hould be considered in every case of abdominal surgery, regardless of the age of the patient, In the over 70 age group, complication and mor tality rates increase significantly and dreadfully when the gallbladde r is left in situ after surgery for gastrointestinal tumors, Incidenta l cholecystectomy is not warranted in patients undergoing palliative p rocedures or in whom life expectancy is less than 6 months.