Acute Appendicitis in the Aged

Acute appendicitis is a common disease, in general, but is rare in the elderly. This report is a clinical review of 148 patients over the age of 60 who, due to acute appendicitis, underwent appendectomies at the Department of General Surgery of Saint Columban Hospital from January 1993 to December 1995. The results are as follows: 1) The overall percentage of the patients over the age of 60 was about 16.4%. 2) The male to female ratio was 1:1.6. 3) The perforation rate was 33.1%. 4) The mean duration of symptoms were 2 days in non-perforated and 4.5 days in perforated appendicitis. 5) The chief complaints were pain (86.5%) and tenderness (88.5%) on right lower quadrant. 6) This disease occurred most frequently in spring and summer. 7) The highest incidence of leukocyte count was 10,000~15,000 per cubic mm of blood (50%). 8) The most frequent postoperative complication was wound infection as 14.2%. 9) sixty-seven cases (45.3%) were accompanied by concomitant disease, the most frequent being hypertention (14.9%). 10) The mean numbers of hospital days were 7.5 in non-perforated and 14 in perforated appendicitis.

Comparison of the Clinical Results for Laparoscopic Cholecystectomy Versus Open Cholecystectomy

We compared 30 cases that had a laparoscopic cholecystectomy(L.C.) with 30 cases which revealed chronic cholecystitis on biopsy among the patients who had a standard open cholecystectomy(O.C.). The patients were treated at the Department of Surgery, Saint Columban Hospital, Mokpo, Korea, from January 1995 to July 1996. The results from the 60 patients are as follows: 1) The ratio of males to females was 1:2 in the L.C. group and 1:0.8 in the O.C. group. The prevalent age was the 6th decade in both groups. 2) Associated diseases were seen in 22 cases(73%) in the L.C. group and 20 cases(67%) in the O.C. group. 3) There were 6 cases(20%) of previous abdominal operations in the L.C. group and 7 cases(23%) in the O.C. group. 4) The mean operation time was 139.8+/-35.7 minutes in the L.C. group and 155.3+/-34.4 minutes in the O.C. group. 5) The mean hospital stay after the operation was shorter in the L.C. group(range: 4~7 days) than in the O.C. group(range:8~12 days). 6) Postoperative complications occurred in 2 cases(7%) in the L.C. group and 8 cases(27%) in the O.C. group. 7) The conversion rate from a laparoscopic cholecystectomy to an open cholecystectomy was 21%(8 cases). 8) Problem experienced during the laparoscopic cholecystectomy were bleeding at the operative field(4 cases), stone drop from gallbladder(3 cases), and bile leakage(1 case). 9) The time until postoperative oral intake was 2 postoperative days in the L.C. group and 4 postoperative days in the O.C. group. 10) The average duration of postoperative pain was 2.6+/-0.6 days in the L.C. group and 4.3+/-1.3 days in the O.C. group. 11) The average duration of narcotic requirement was 2.4+/-0.6 days in the L.C. group and 3.8+/-1.8 days in the O.C group.