Abstract
Background
While early cholecystectomy is generally accepted as the standard procedure for young and fit patients with acute cholecystitis, controversy exits on the management of elderly and severely sick patients. We postulated that primary cholecystectomy is feasible in this subgroup. The aim of this study was to compare the outcomes of young and fit patients to those of elderly patients undergoing surgery for acute cholecystitis.
Methods
The outcomes of elderly patients (≥70 years) undergoing surgery for acute cholecystitis in a primary care center in Germany were retrospectively compared to those of younger patients (<70 years).
Results
152 patients, 74 aged ≥ 70 years (study group) and 78 < 70 years (control) were included for analysis. The study group was significantly older at the time of surgery (78 vs. 68 years, p = 0.02). Severe cholecystitis was seen in a significant number of cases in the study group, p = 0.01. Equally, the mean WBC (19.5 vs. 17, p = 0.02), CRP (26 vs. 22, p = 0.04) and APACHE II score (17 vs. 8, p = 0.01) were significantly higher in the study group. There was no significant difference in the duration of anesthesia (123 vs. 133 min, p = 0.70) and surgery (72 vs. 81 min, p = 0.90) amongst both groups. There was no significant difference in rate of complication amongst both groups (24 vs. 14 %, p = 0.11). Two cases of mortality were recorded (1.3 %) in the study group.
Conclusion
The age of the patient cannot be the sole factor in deciding whether or not a patient with acute cholecystitis is fit for surgery.
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This study was performed in accordance with the Helsinki Declaration on human rights and was approved by the departmental board of review at the St. Remigius Hospital.
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An informed consent was obtained from all subjects.
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Ambe, P.C., Weber, S.A., Christ, H. et al. Primary cholecystectomy is feasible in elderly patients with acute cholecystitis. Aging Clin Exp Res 27, 921–926 (2015). https://doi.org/10.1007/s40520-015-0361-0
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DOI: https://doi.org/10.1007/s40520-015-0361-0