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Minerva Chir. 2019 Aug;74(4):289-296. doi: 10.23736/S0026-4733.19.07891-X. Epub 2019 Feb 13.

Cholecystectomy for acute cholecystitis in octogenarians: impact of advanced age on postoperative outcome.

Author information

1
Unit of Emergency Surgery, St. Orsola University Hospital, Alma Mater Studiorum University, Bologna, Italy - samuelevaccari@gmail.com.
2
Unit of Emergency Surgery, St. Orsola University Hospital, Alma Mater Studiorum University, Bologna, Italy.
3
"Advanced Surgical Technologies" Department of Surgical Sciences, Umberto I University Hospital, La Sapienza University, Rome, Italy.
4
Unit of Plastic Surgery and Burn Care, Arnas Civico Hospital, Palermo, Italy.

Abstract

BACKGROUND:

The number of surgical operations in elderly patients is increasing due to the aging demographics of western populations. The aim of the present study was to investigate the peri-operative outcome of octogenarian patients undergoing cholecystectomy for acute cholecystitis.

METHODS:

We performed a retrospective analysis including all patients who underwent cholecystectomy for acute cholecystitis from January 2013 to December 2017. Records were collected prospectively from two centers: 1) Unit of Emergency Surgery, St. Orsola University Hospital, Alma Mater Studiorum University, Bologna; 2) "Advanced Surgical Technologies" Department of Surgical Sciences, Umberto I University Hospital, La Sapienza University, Rome. Patients were divided by age (≥ or <80 years) and peri-operative outcomes were compared.

RESULTS:

During the study period, 464 patients were operated for acute cholecystitis in the two centers. Sixty-three (14%) patients were octogenarians (group 1) and median age was 84.8±3.9 years. Four hundred and one patients (86%) were younger than 80 years (group 2) with median age of 55.3±15.3 years. Forty-four per cent of group-1 patients underwent laparoscopic cholecystectomy versus 81% of the younger group (P<0.01). Elderly patients had a higher percentage of overall complications (25% vs. 9%; P=0.03) and a longer median postoperative length of stay (7.2±6.8 vs. 4.6±7.7; P=0.04). Overall mortality was 1%: two patients died in group-1 and one in group-2 (P=0.50). However, on multivariate analysis age older than 80 years was not found to be an independent risk factor for postoperative morbidity and mortality.

CONCLUSIONS:

The results of this study suggest that cholecystectomy for acute cholecystitis in octogenarians is a relatively safe procedure with an acceptable risk of complications and a postoperative hospital stay comparable to younger ones.

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