Cholecystectomy in the elderly.

A 4-year retrospective review of 212 patients over 70 years of age who underwent elective and emergency cholecystectomies was undertaken. Elective procedures were performed in 119 patients (76 women, 43 men) whereas 93 patients (43 women, 50 men) underwent emergency surgery. Complications developed in 25 and 34 patients, respectively. In the elective group, the most common complication involved the cardiovascular system, whereas sepsis with multiple organ failure accounted for all of the deaths in the emergency group. Among the 212 patients studied, there was a 3 percent mortality rate in the elective group and a 10 percent mortality rate in the emergency group, with an overall mortality rate of 6 percent. The results indicated that since the risks of elective cholecystectomy are relatively low in the elderly and the risks of cholecystectomy performed as an emergency are considerably higher (10 percent), symptomatic elderly patients with gallstones should be considered good candidates for early elective cholecystectomy.

Cholecystectomy in the elderly.

A two-year retrospective review of 137 patients over 70 years of age undergoing cholecystectomy, from January 1, 1983 to January 1, 1985, was done at Mount Sinai Medical Center of Miami Beach. This study focused on the clinical presentations, surgical management, and overall morbidity and mortality of this operative procedure in the elderly. There were 81 women and 56 men in the study ranging in age from 70 to 96. Elective procedures were performed in (78/137) 57 per cent of the patients while (59/137) 43 per cent underwent emergency surgery. Elective procedures were performed in (55/81) 68 per cent of the women and (23/56) 41 per cent of the men. Emergency surgery was required in (26/81) 32 per cent of the women and (33/56) 60 per cent of the men. Complications developed in (16/78) 20 per cent of the elective cases and (19/59) 32 per cent of the emergency cases. In the elective group, the most common complication involved the cardiovascular system. Sepsis with multiple organ failure accounted for all the deaths in the emergency group. Among the 137 patients in this series, there was a (3/78) 3.8 per cent mortality in the elective group and a (7/59) 12 per cent mortality in the emergency group with an overall mortality of (10/137) 7.3 per cent. The purpose of this study was to highlight the necessity for aggressive surgical management of biliary tract disease in the elderly.(ABSTRACT TRUNCATED AT 250 WORDS)