A clinical comparison between laparoscopic and open cholecystectomy in elderly patients / 中国微创外科杂志

ABSTRACT

Objective To compare the safety between laparoscopic cholecystectomy (LC) and open cholecystectomy (OC) for benign gallbladder diseases in elderly patients. Methods A total of 120 patients above the age of 60 with indications for cholecystectomy and tolerance to general anesthesia were divided into two groups (LC Group and OC Group), in admission order of odd or even, with 60 patients in each group. Peri-operative parameters including operation time, analgetic consumption, postoperative gastrointestinal recovery time, length of duration with fluid infusion, length of bed rest, postoperative complications, and hospital stay were compared between the two groups. Serum total triiodothyronine (TT3) and thyroid stimulating hormone (TSH) levels, as well as the functional recovery of the abdominal muscles, were also recorded and compared. Results Peri-operative parameters were better in the LC Group than in the OC Group. Serum TT3 levels decreased significantly after surgery in both the LC Group (F=8.26,P=0.000) and the OC Group (F=124.70,P=0.000), with a more significant difference in the OC Group.Postoperatively,serum TSH levels decreased insignificantly in the LC Group (F=1.87,P=0.157) and significantly in the OC Group (F=27.24,P=0.000). Lasegue’s test at 7 days after surgery showed significantly higher leg-raising times in the LC Group than in the OC Group (t=3.640,P=0.000). Conclusions Laparoscopic cholecystectomy is superior to open cholecystectomy in the treatment of benign gallbladder diseases in elderly patients.