The impact of dementia on surgical outcomes of laparoscopic cholecystectomy for symptomatic cholelithiasis and acute cholecystitis: A retrospective study. Issue 3 (7th August 2019)

• Record Type: Journal Article
• Authors: Ninomiya, Shigeo; Amano, Shota; Ogawa, Tadashi; Ueda, Yoshitake; Shiraishi, Norio; Inomata, Masafumi; Shimoda, Katsuhiro
• Is Part Of: Asian journal of endoscopic surgery. Volume 13:Issue 3(2020)
• Page Start: 351
• Page End: 358
• Publication Date: 2019-08-07
• Subjects: acute cholecystitis -- dementia -- laparoscopic cholecystectomy; Endoscopic surgery -- Periodicals; Endoscopic surgery -- Asia -- Periodicals; 617.05705
• DOI: 10.1111/ases.12743
• Languages: English
• ISSNs: 1758-5902

Abstract

Abstract: Introduction: The aim of this study was to clarify the impact of dementia on surgical outcomes of laparoscopic cholecystectomy for symptomatic cholelithiasis and acute cholecystitis. Methods: We reviewed medical data of 96 patients who underwent laparoscopic cholecystectomy for symptomatic cholecystitis and acute cholecystitis. The patients were divided into the dementia group (n = 18) and non‐dementia group (n = 78). Clinical features of the patients and surgical outcomes were compared between the two groups. Results: Mean age and rates of The American Society of Anesthesiologists Physical Status classification score > 2 in the dementia group were significantly higher than those of the non‐dementia group ( P < .001, P = .008, respectively). Incidences of acute cholecystitis and the rate of percutaneous transhepatic gallbladder drainage in the dementia group were significantly higher than those of the non‐dementia group ( P = .009, P = .01, respectively). The rates of conversion to laparotomy and non‐surgical complications in the dementia group were higher than those in the non‐dementia group ( P = .02, P = .03, respectively). Postoperative hospital stay in the dementia group was significantly longer than that in the non‐dementia group (15.2 ± 9.3 vs 8.2 ± 3.2 days, P = .009). Subgroup analysis of patients with acute cholecystitis showed postoperative hospital stay in the dementia group to be significantly longer than that in the non‐dementia group (18.7 ± 10.7 vs 10.3 ± 4.2 days, P = .03). Conclusion: Patients with dementia who underwent laparoscopic cholecystectomy have a high incidence of acute cholecystitis and a high rate of percutaneous transhepatic gallbladder drainage, which may result in increased rates of conversion to laparotomy and prolong the postoperative hospital stay.