Cholecystectomy in patients above 70: review of 153 cases
Reiss, R.; Hoffman, S.; Deutsch, A.A.
Mount Sinai Journal of Medicine new York 49(1): 71-75
1982
ISSN/ISBN: 0027-2507 PMID: 7045639 Document Number: 187247
Advances in surgery and anesthesia have revolutionized the surgical care of the biliary tract in the gastric age group. This report deals with 153 patients aged 70 and over and with a series of 1000 consecutive cholecystectomies. All data were computer analyzed. Early surgery was performed within 49 h after full diagnostic investigation and adequate preparation in all patients with acute or subacute complications. One stage definitive procedure including cholecystectomy, operative cholangiography and complete correction of pathology in the common bile duct were preferred to temporary measures, such as cholecystostomies. Careful anesthesia management is necessary before, during and after surgery. The mortality in this series was 2.6%, considerably lower than other reported series in this age group. Complicating factors, such as infected bile, jaundice, choledochal stones and gangrenous changes, are much more frequent in elderly patients than in other age groups. The principles outlined combining early surgery, complete correction of biliary pathology and intensive postoperative care whenever needed, have resulted in dramatic reduction of mortality and morbidity in the elderly patient.