Cholecystectomy for acute cholecystitis in octogenarians: impact of advanced age on post-operative outcome
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 under- went 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 rela- tively safe procedure with an acceptable risk of complications and a postoperative hospital stay comparable to younger ones.
(Cite this article as: Vaccari S, Lauro a, Cervellera M, Palazzini g, Casella g, Santoro a, et al. Cholecystectomy for acute cholecystitis in octogenarians: impact of advanced age on postoperative outcome. Minerva Chir 2019;74:000-000. DOi: 10.23736/S0026-4733.19.07891-X)