Pérez MA, Roesch DF, Díaz BF, Martínez FS

Language: Spanish
References: 23
Page: 35-40
PDF size: 73.20 Kb.

ABSTRACT

Objective: To compare the morbidity and mortality of cholecystectomy through laparoscopy in patients younger than 60 years with those over 60 years.
Setting: Third level health care hospital.
Design: Clinical, retrospective, observational, comparative study.
Statistical analysis: Chi square and Student’s t tests.
Patients and methods: We reviewed the clinical records of patients over 60 years of age subjected to laparoscopic cholecystectomy between June 1992 and December 1998 (Group 1), and compared them with a similar group, subjected to the same procedure but under 60 years of age (Group 2). We evaluated age, gender, concomitant diseases, surgical time, post-operative complications, hospital stay, and mortality.
Results: Average age of Group 1 was 67.6 years and for Group 2, 40.8 years. In both groups, women predominated over men at a 4:1 ratio. Patients over 60 years presented risk factors in 41.7% (diabetes mellitus, arterial hypertension, and ischemic cardiopathy), whereas in those under 60 years only 7.2% presented risk factors. In the elderly patients a larger number of complications related to their lithiasic disease was found, such as: scleroatrophic gallbladder and cholecystocolonic fistula. Besides, one patient coursed with liver cirrhosis and another with hepatocarcinoma. Frequency of choledocolithiasis was similar in both groups. Surgical time, transoperative events, and average hospital stay were similar for both groups. Morbidity was higher in the elderly patients, consisting of decompensation of their diabetes and arterial hypertension, and one patient presented pulmonary thromboembolism, causing death of the patient.
Conclusion: It can be concluded that patients over 60 years of age are at a higher risk of complications than the younger ones. Therefore, the surgeon must detect the risk factors before surgery and increase control and monitoring measures during the post-operative period.

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