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 8 1 % 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.

Cholecystectomy for acute cholecystitis in octogenarians: impact of advanced age on post-operative outcome / Vaccari, Samuele; Lauro, Augusto; Cervellera, Maurizio; Palazzini, Giorgio; Casella, Giovanni; Santoro, Alberto; Mascagni, Domenico; Ursi, Pietro; Gulotta, Eliana; D'Errico, Umberto; Ussia, Alessandro; De Siena, Nicolò; Bianchini, Stefania; D'Andrea, Vito; Tonini, Valeria. - In: MINERVA CHIRURGICA. - ISSN 0026-4733. - 74:4(2019), pp. 289-296. [10.23736/S0026-4733.19.07891-X]

Cholecystectomy for acute cholecystitis in octogenarians: impact of advanced age on post-operative outcome

Vaccari, Samuele;Lauro, Augusto;Palazzini, Giorgio;Casella, Giovanni;Santoro, Alberto;Mascagni, Domenico;Ursi, Pietro;D'andrea, Vito
Membro del Collaboration Group
;
2019

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 8 1 % 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.
Acute; Aged 80; Cholecystectomy; Cholecystitis; Over; Adolescent; Adult; Age Factors; Aged; Aged, 80 and over; Cholecystitis, Acute; Female; Humans; Male; Middle Aged; Retrospective Studies; Treatment Outcome; Young Adult; Cholecystectomy
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Cholecystectomy for acute cholecystitis in octogenarians: impact of advanced age on post-operative outcome / Vaccari, Samuele; Lauro, Augusto; Cervellera, Maurizio; Palazzini, Giorgio; Casella, Giovanni; Santoro, Alberto; Mascagni, Domenico; Ursi, Pietro; Gulotta, Eliana; D'Errico, Umberto; Ussia, Alessandro; De Siena, Nicolò; Bianchini, Stefania; D'Andrea, Vito; Tonini, Valeria. - In: MINERVA CHIRURGICA. - ISSN 0026-4733. - 74:4(2019), pp. 289-296. [10.23736/S0026-4733.19.07891-X]
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11573/1287255
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