GALLSTONE DISEASE IN PATIENTS OVER THE AGE OF 80 - SURGERY OR LONG-TERM MEDICAL-TREATMENT

Objective: Growth in the geriatric population is increasing the biliar y pathology of the elderly, thus becoming more frequent in the medical environment. The different therapeutic methods that are at present in use, should be applied to this group, employing open cholecystectomy as a reference. Material and methods: During a period of 5 years we ha ve attended 209 patients over the age of 80 (13.8 of the fetal of gall stones), 76 patients (36.4%) underwent surgery and in 133 cases (63.6% ) another therapeutic method was decided upon. The progression, compli cations and mortality rate are studied closely herein. Results: The ma jority, 156 (74.6%) were not previous admissions and in 108 (51.7%) th e symptoms had been present for less than one month. Eighty four (40.2 %) were suffering from jaundice on admission (on average 4 days) and 8 9 (42.6%) showed signs of inflammation. 23 patients (11%) were submitt ed only to an endoscopic sphincterotomy. Of those patients who underwe nt surgery, 52 (67.5%) had a range of inflammatory phenomena. Open cho lecystectomy was carried out on 65 patients (85.5%). Sixty one patient s (29.2%) presented complications, 38 (50%) in the group underwent sur gery. Twenty eigh patients (13.4%) died - 9 (11.8%) of the 76 patients were operated upon. Conclusions: Elderly patients can undergo surgery in selected cases with an acceptable mortality rate and high morbidit y. Surgery is recommended in those of a lesser age, not always possibl e as many of them lacked prior symptoms.