Laparoscopic cholecystectomy versus open cholecystectomy in elderly patients with acute holecystitis: retrospective study

CH Chau, CN Tang, WT Siu, JPY Ha, MKW Li
Department of Surgery, Pamela Youde Nethersole Eastern Hospital

OBJECTIVE. To study the safety and efficacy of laparoscopic cholecystectomy for acute cholecystitis in elderly patients by comparing the results with open cholecystectomy.

DESIGN. Retrospective study.

SETTING. Regional hospital, Hong Kong.

SUBJECTS AND METHODS. Patients aged 75 years or older undergoing laparoscopic cholecystectomy for acute cholecystitis between January 1994 and December 1999 were selected from the database. The comparison group comprised patients from the same age-group who underwent open cholecystectomy for acute cholecystitis during the same period.

MAIN OUTCOME MEASURES. Operating time, hospital stay, morbidity, and mortality.

RESULTS. Thirty-one patients underwent laparoscopic surgery and 42 had open surgery. The demographic data and co-morbidities were comparable between the two groups. The postoperative hospital stay was significantly shorter for patients undergoing laparoscopy (P=0.03). The overall morbidity rate was significantly lower for patients undergoing laparoscopy (P<0.05). There was, however, no statistical significant difference in the mortality rate. There was no major bile duct injury for patients in either group.

CONCLUSION. Laparoscopic cholecystectomy is a safe procedure for acute cholecystitis in elderly patients, resulting in fewer complications and shorter hospital stay than open cholecystectomy.

Hong Kong Med J 2002;8:394-9

Key words: Aged; Cholecystectomy, laparoscopic; Cholecystitis