Laparoscopic cholecystectomy in the elderly and young: a comparative study.

BACKGROUND/AIMS: To assess the safety and effectiveness of simple laparoscopic cholecystectomy in the elderly patients and to compare it with that in younger patients.

METHODOLOGY: All patients underwent laparoscopic cholecystectomy in a four year period in a university hospital were retrospectively studied. They were divided in two groups according to the age: group A (65 years and above) and group B (below 65 years). Information about the diagnosis, operation time, intraoperative complications, conversion to open cholecystectomy, length of hospital stay, morbidity and mortality were collected.

RESULTS: A total of 1539 patients underwent laparoscopic cholecystectomy during the study period, 234 (15.2%) patients in group A and 1305 (84.8%) patients in group B. Group A experienced higher rates of conversion to laparotomy (9% vs. 2.1%, p<0.005), longer operative time (105.5 vs. 89.7 minutes, p<0.005), longer hospital stay (6.2 vs. 2.1 days, p<0.005) and more morbidity (13.7% vs. 5.1%, p<0.005). The overall mortality was 0.3% with no significant statistical difference between both groups.

CONCLUSIONS: Laparoscopic cholecystectomy is feasible in the elderly patients with low mortality and morbidity. However, it is associated with higher conversion rate, longer operation time, longer hospital stay and higher morbidity compared with younger patients.