Nikfarjam Mehrdad, Yeo David, Perini Marcos, Fink Michael A, Muralidharan Vijayaragavan, Starkey Graham, Jones Robert M, Christophi Christopher
Department of Surgery, University of Melbourne, Melbourne, Victoria, Australia.
ANZ J Surg. 2014 Dec;84(12):943-8. doi: 10.1111/ans.12313. Epub 2013 Aug 1.
The independent influence of advanced age on outcomes in contemporary series treated by early cholecystectomy is undetermined.
Elderly patients, aged 80 years and older, with histology proven acute cholecystitis treated by cholecystectomy on initial presentation between 2005 and 2011 were compared to all others.
In total, 411 patients had histologically proven acute cholecystitis, of whom 71 (17%) were aged 80 years and older. Elderly patients were more likely to have ischaemic heart disease, underlying diabetes and chronic renal failure. There was greater conversion from laparoscopic to open surgery in the elderly (21% versus 7%; P = 0.001). Elderly patients were more likely to have gangrenous cholecystitis (44% versus 31%; P = 0.033) and common bile duct stones (27% versus 17%; P = 0.048). Elderly patients had more complications (31% versus 13%; P < 0.001), a higher mortality rate (4% versus 1%; P = 0.038) and a longer median post-operative length of stay (7 days versus 3 days; P < 0.001). Age ≥ 80 (P = 0.004) was an independent risk factors for complications.
Age 80 years and older is independently associated with increased morbidity following cholecystectomy for treatment acute cholecystitis at initial presentation.
在当代早期胆囊切除术治疗的系列研究中，高龄对治疗结果的独立影响尚不确定。
将2005年至2011年首次就诊时接受胆囊切除术治疗的80岁及以上组织学确诊为急性胆囊炎的老年患者与所有其他患者进行比较。
共有411例患者经组织学确诊为急性胆囊炎，其中71例（17%）年龄在80岁及以上。老年患者更易患缺血性心脏病、基础糖尿病和慢性肾衰竭。老年患者中转开腹手术的比例更高（21%对7%；P = 0.001）。老年患者更易患坏疽性胆囊炎（44%对31%；P = 0.033）和胆总管结石（27%对17%；P = 0.048）。老年患者并发症更多（31%对13%；P < 0.001），死亡率更高（4%对1%；P = 0.038），术后中位住院时间更长（7天对3天；P < 0.001）。年龄≥80岁（P = 0.004）是并发症的独立危险因素。
80岁及以上患者在首次就诊时因急性胆囊炎行胆囊切除术后，发病率独立增加。
