Impact of the introduction of laparoscopic cholecystectomy on the population aged 70 and over

Background/Aims: Laparoscopic cholecystectomy is reported to be better tole rated than open cholecystectomy by patients aged 70 and over. We evaluate i ts impact on patients aged 70 and over, from one single center. Methodology: We review 427 cholecystectomies performed in one single centre , from November 1992 through November 1999. We consider 23 patients, 70 yea rs old or older at the time of surgery. The following objective parameters were considered and compared with the younger population: length of stay in the hospital; mean preoperative stay; mean postoperative stay; incidence o f risk factors; postoperative complications. A questionnaire was also maile d to all individual 427 patients. Results: Length of stay in the hospital declined in both population, during the time interval considered. The incidence of risk factors, both major an d minor, increases consistently with age from less than 1% below the age of 30 to about 62% in the eighth decade and over. Major postoperative complic ations were 4.34% in patients greater than or equal to 70 vs. 2.8% in patie nts <70 years of age. Mortality was nil in both groups. Ninety per cent rep orted complete disappearance of preoperative symptoms. Conclusions: Laparoscopic cholecystectomy in geriatric patients is safe and risks are reasonably low. Selection of patients must be done on strict ind ications.