Role of laparoscopic cholecystectomy in Geriatric patients (>60 years of age).

Abstract

Objectives: In elderly patients, recent research has also questioned the effectiveness of this surgery. The objective of our study is to evaluate the safety and applicability of laparoscopic cholecsytectomy in geriatric patients (over 60 year of age) for the symptomatic cholelothiasis. Study Design: Prospective and observational study. Setting: Different surgical wards at LUHMS Jamshoro / Hyderabad who undergone for laparoscopic cholecystectomy. Period: One year from 01-03-2017 to 28-02-2018. Material & Methods: 100 patients of 60 years of age and above having gall stone disease. All elderly patients of cholelithiasis (over 60 years) presenting with symptoms of gallstone disease will be included in this study irrespective of their sex. Results:  A total of 100 patients were included in this study. The minimum and maximum age range was 65 to 83 years. The mean age + SD, was 69.72 + 10.31 years. Most of the patients i.e. 60 (60%) were seen in the age group 60 to 65 years, 45(5.0%) patients were observed in the age group > 65 years. 52.0% (n=52) patients had co-morbidities followed by hypertension in 20 (20.0%), Diabetes Mellitus 15 (15.0%), COPD 7 (7.0%), Coronary artery disease 9 (9.0%) and cardiac arrhythmias 1 (1.0%) patient only. Most of the patients had duration of operation 90 to 120 minutes. The mean + SD operative time was 90.12 + 35.5 (60 to 250 minutes). Total operative complications were seen in 15(15.0%) patients who had injury of CBD in 3 patients and 4 patients had bleeding, failed to clip cystic duct 2 cases and 3 patients died. Nineteen (19.0%) elderly patients had postoperative complications and they were not undergone for laparoscopic surgery due to low intensity and occurrence. Overall mortality was seen 1(1.0%) because of acute myocardial infarction and it was occurred on the second day of the operation. Conclusion: Laparoscopic cholecystectomy is as safe and effective in old patients as compared to young patients with less complications, morbidity and mortality are very low and lesser than open cholecystectomy. The pain free post-operative period and early ambulation lead to saving of valuable working hours.