Safety and Effectiveness of Laparoscopic Cholecystectomy in Acute Cholecystitis Patients who are 80 Years of Age or Older

Abstract

Laparoscopic cholecystectomy (LC) is minimally invasive and its benefits are widely known, but there are few reports of its usefulness in the elderly. In this study, we evaluated the usefulness of LC for acute cholecystitis in the elderly. The study subjects were a total 205 patients with acute cholecystitis who had undergone emergency cholecystectomy between January 2012 and December 2020, and were divided by age into two groups, as follows: the elderly group, consisting of patients who were 80 years of age or older (n = 57) and the non-elderly group, consisting of patients who were less than 80 years old (n = 148). The serum albumin levels were significantly lower in the elderly group. The preoperative serum C-reactive protein levels, CCI and ASA, and the likelihood of being under anticoagulant/antiplatelet therapy were also higher in the elderly group, as was the proportion of patients with acute cholecystitis of moderate or greater severity. There were no differences in the surgical or postoperative factors between the two groups, but the length of hospital stay was significantly longer in the elderly group.

We considered that LC can be performed safely in elderly patients who have the ability to tolerate the procedure, but that intensive perioperative management and early rehabilitation intervention are necessary to avoid delayed postoperative recovery.