Gallbladder surgery in patients over 60: is there an increased risk?

We reviewed the records of 101 patients over the age of 60 who had exploration and cholecystectomy in 1982 at Norfolk General Hospital. There were 52 elective and 49 emergency cases. Women comprised 57.4% of the patients, and almost 50% of the patients were over the age of 70. Forty-nine percent of the cases were emergencies. All but two of the patients had cholecystectomy. The average hospital stay was 12 days for the elective group and 19 days for the urgent group. Complications extended the average hospital stay to 23 days. Although complications developed in 35 patients, only 14 had major complications that were life-threatening and/or extended the hospital stay. Of these, four were in elective cases (7%) and the remainder (21%) were in the urgent group. A major complication more than doubled the average hospital stay to 29 days. There were three deaths (3% of the entire group), all in patients who had emergency exploration, and all in patients over age 70. We advocate earlier elective cholecystectomy for patients with symptomatic cholelithiasis--before patients reach an older age, when associated systemic diseases increase their overall risk should emergency operation be necessary.