Department of General and Digestive Surgery, Farhat Hached University Hospital, Faculty of Medicine of Sousse, Sousse, Tunisia.
Geriatr Gerontol Int. 2023 Sep;23(9):671-675. doi: 10.1111/ggi.14643. Epub 2023 Jul 18.
Advances in laparoscopic surgery and perioperative care have improved the prognosis of operated patients, especially the oldest among them. This study aimed to assess the outcomes of early laparoscopic cholecystectomy for acute calculous cholecystitis in older adult patients.
A retrospective analysis was carried out of 567 patients who underwent early laparoscopic cholecystectomy for acute calculous cholecystitis between January 2003 and July 2021. The outcomes of older adult patients (≥ 75 years) were compared with those of younger patients.
The older adult group had significantly more patients with an American Society of Anesthesiologists score ≥3 (37.5% vs 8.3%; P < 0.001) and more severe acute calculous cholecystitis (grade II; 82.8% vs 67%; P = 0.01). There were no significant differences regarding operative time (90 vs 80 min; P = 0.064), conversion rate (20.3% vs 13.5%; P = 0.144), and both intra- and postoperative morbidity, principally bile duct injuries (1.6% vs 0%; P = 0.113) and bile leakage (0% vs 1.2%; P = 1).
Early laparoscopic cholecystectomy could be proposed safely for older adult patients with mild and moderate acute cholecystitis. Geriatr Gerontol Int 2023; 23: 671-675.
腹腔镜手术和围手术期护理的进步改善了手术患者的预后，尤其是年龄最大的患者。本研究旨在评估老年患者早期腹腔镜胆囊切除术治疗急性结石性胆囊炎的结果。
对 2003 年 1 月至 2021 年 7 月期间行早期腹腔镜胆囊切除术治疗急性结石性胆囊炎的 567 例患者进行回顾性分析。比较了老年患者（≥75 岁）和年轻患者的结局。
老年组患者的美国麻醉医师协会评分≥3 分的患者明显更多（37.5%比 8.3%；P<0.001），且急性结石性胆囊炎更严重（II 级；82.8%比 67%；P=0.01）。手术时间（90 分钟比 80 分钟；P=0.064）、中转率（20.3%比 13.5%；P=0.144）以及术中术后并发症发生率，主要是胆管损伤（1.6%比 0%；P=0.113）和胆漏（0%比 1.2%；P=1）均无显著差异。
对于轻度和中度急性胆囊炎的老年患者，可以安全地提出早期腹腔镜胆囊切除术。
老年医学与老年健康 2023；23：671-675。
