Journal Article

Outcomes after laparoscopic cholecystectomy in patients older than 80 years: two-years follow-up

Avendaño-Morales, Violeta, Rojas-López, Susana, Ramírez-Giraldo, Camilo, Venegas-Sanabria, Luis Carlos

2024

Overview

Background The laparoscopic cholecystectomy is the treatment of choice for patients with benign biliary disease. It is necessary to evaluate survival after laparoscopic cholecystectomy in patients over 80 years old to determine whether the long-term mortality rate is higher than the reported recurrence rate. If so, this age group could benefit from a more conservative approach, such as antibiotic treatment or cholecystostomy. Therefore, the aim of this study was to evaluate the factors associated with 2 years survival after laparoscopic cholecystectomy in patients over 80 years old. Methods We conducted a retrospective observational cohort study. We included all patients over 80 years old who underwent laparoscopic cholecystectomy. Survival analysis was conducted using the Kaplan‒Meier method. Cox regression analysis was implemented to determine potential factors associated with mortality at 24 months. Results A total of 144 patients were included in the study, of whom 37 (25.69%) died at the two-year follow-up. Survival curves were compared for different ASA groups, showing a higher proportion of survivors at two years among patients classified as ASA 1–2 at 87.50% compared to ASA 3–4 at 63.75% ( p  = 0.001). An ASA score of 3–4 was identified as a statistically significant factor associated with mortality, indicating a higher risk (HR: 2.71, CI95%:1.20–6.14). Conclusions ASA 3–4 patients may benefit from conservative management due to their higher risk of mortality at 2 years and a lower probability of disease recurrence.

• Publisher: BioMed Central,BioMed Central Ltd,Springer Nature B.V,BMC
• Subject: Age groups / Aged patients / Aged, 80 and over / Analysis / Antibiotics / Cardiovascular disease / Care and treatment / Cholecystectomy / Cholecystectomy, Laparoscopic - methods / Cholecystitis / Cholecystitis, Acute - surgery / Cholecystostomy - methods / Diseases / Dissection / Elderly / Evidence-based medicine / Follow-Up Studies / Gallbladder / Gallbladder diseases / Gallbladder Diseases - surgery / Humans / Internal Medicine / Laparoscopic surgery / Laparoscopy / Life expectancy / Medical research / Medicine / Medicine & Public Health / Medicine, Experimental / Morbidity / Mortality / Mortality risk / Observational studies / Older people / Pancreatitis / Patient outcomes / Regression analysis / Relapse / Retrospective Studies / Software / Statistical analysis / Statistical power / Surgeons / Surgery / Surgical outcomes / Survival / Survival analysis / Treatment Outcome / Variables