Feasibility and safety of single-incision laparoscopic cholecystectomy in elderly patients: A single institution, retrospective case series. (October 2017)

• Record Type: Journal Article
• Authors: Wakasugi, Masaki; Tanemura, Masahiro; Furukawa, Kenta; Tei, Mitsuyoshi; Suzuki, Yozo; Masuzawa, Toru; Kishi, Kentaro; Akamatsu, Hiroki
• Is Part Of: Annals of medicine and surgery. Volume 22(2017)
• Page Start: 30
• Page End: 33
• Publication Date: 2017-10
• Subjects: Age -- Octogenarian -- Laparoscopic cholecystectomy -- Single-incision laparoscopic surgery (SILS) -- Single-incision laparoscopic cholecystectomy (SILC); Surgery -- Periodicals; Medicine -- Periodicals; General Surgery -- Periodicals; Education, Medical -- Periodicals; Periodicals; 617
• DOI: 10.1016/j.amsu.2017.08.024
• Languages: English
• ISSNs: 2049-0801

Abstract

Abstract: Introduction: To evaluate the feasibility and safety of single-incision laparoscopic cholecystectomy (SILC) for uncomplicated gallbladder in elderly patients. Materials and Methods: A retrospective analysis of 810 patients undergoing SILC from May 2009 to October 2016 at Osaka Police Hospital was performed, and the outcomes of the patients aged < 80 years and the patients ≥ 80 years were compared. Results: The median operative times of patients <80 years and patients ≥80 years were 100 min and 110 min, respectively (p = 0.4). The conversion rates to a different operative procedure (multi-port laparoscopic cholecystectomy or open cholecystectomy) were 3% (22/763) of patients < 80 years and 0% of patients ≥ 80 years (p = 0.6). Perioperative complications were seen in 6% (46/763) of patients < 80 years and 17% (8/47) of patients ≥ 80 years (p < 0.05). Pneumonia was seen in 0% (0/763) of patients < 80 years and 4% (3/47) of patients ≥ 80 years (p < 0.05). There was no mortality in either group. The median postoperative hospital stay was 4 days for patients <80 years and 5 days for patients ≥80 years (p < 0.05). Conclusion: SILC for uncomplicated gallbladder could be performed for patients ≥ 80 years with acceptable morbidity and mortality as compared with the previous reports, though the complication rate of patients ≥ 80 years was higher than that of patients < 80 years. Highlights: The operative time and the conversion rate of patients ≥80 years after single-incision laparoscopic cholecystectomy were comparable to those of patients <80 years. The incidence of pneumonia was significantly higher in patients ≥80 years than in patients <80 years. Single-incision laparoscopic cholecystectomy could be performed in patients ≥80 years with acceptable morbidity and mortality.