Is Surgery Safe in Gallstone-Related Acute Diseases in Elderly Patients?

Objective: To determinate the safety of the surgical treatment of acute biliary pancreatitis and acute cholecystitis in elderly patients.

Study Design: Observational study.

Place And Duration Of Study: Department of General Surgery, Elazig Training and Research Hospital, Elazig, Turkey, from January 2010 to July 2012.

Methodology: Records of 172 patients with acute complications of biliary calculi, aged over 65 years, were included. Patients were assessed for demographic information, hospitalisation diagnosis, leucocyte count, ASA classification, treatment type, conversion rates, length of hospital stay, morbidity and mortality. Statiscal analyses were performed using the SPSS version 20.0.

Results: The sample included 128 females (74.4%) and 44 males (25.6%). Patients' diagnoses included 135 (78.4%) acute cholecystitis and 37 (21.6%) acute pancreatitis. Medical treatment was offered to 113 patients (65.7%). Open cholecystectomy was directly performed in 17 patients (9.9%). Two patients (4.8%) were converted to an open cholecystectomy during surgery, while a laparoscopic cholecystectomy was performed sucessfully on 42 patients (24.4%). Those who underwent surgery were discharged as cured, except for minimal surgical complications.

Conclusion: Treatment choice in acute gallstone complications in the elderly depends on the patient's general condition, severity of the disease, and ASAscore. Early laparoscopic cholecystectomy is a good option in selected elderly patients with acute cholecystitis and non-severe acute biliary pancreatitis.