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Outcomes of cholecystectomy for treatment of acute cholecystitis in octogenarians
Author(s) -
Nikfarjam Mehrdad,
Yeo David,
Perini Marcos,
Fink Michael A.,
Muralidharan Vijayaragavan,
Starkey Graham,
Jones Robert M.,
Christophi Christopher
Publication year - 2014
Publication title -
anz journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.426
H-Index - 70
eISSN - 1445-2197
pISSN - 1445-1433
DOI - 10.1111/ans.12313
Subject(s) - medicine , cholecystectomy , cholecystitis , acute cholecystitis , diabetes mellitus , surgery , bile duct , gallbladder , general surgery , endocrinology
Background The independent influence of advanced age on outcomes in contemporary series treated by early cholecystectomy is undetermined. Methods Elderly patients, aged 80 years and older, with histology proven acute cholecystitis treated by cholecystectomy on initial presentation between 2005 and 2011 were compared to all others. Results In total, 411 patients had histologically proven acute cholecystitis, of whom 71 (17%) were aged 80 years and older. Elderly patients were more likely to have ischaemic heart disease, underlying diabetes and chronic renal failure. There was greater conversion from laparoscopic to open surgery in the elderly (21% versus 7%; P = 0.001). Elderly patients were more likely to have gangrenous cholecystitis (44% versus 31%; P = 0.033) and common bile duct stones (27% versus 17%; P = 0.048). Elderly patients had more complications (31% versus 13%; P < 0.001), a higher mortality rate (4% versus 1%; P = 0.038) and a longer median post‐operative length of stay (7 days versus 3 days; P < 0.001). Age ≥ 80 ( P = 0.004) was an independent risk factors for complications. Conclusion Age 80 years and older is independently associated with increased morbidity following cholecystectomy for treatment acute cholecystitis at initial presentation.