Research Article
BibTex RIS Cite

DIFFERENCES AND RELIABILITY OF LAPAROSCOPIC CHOLECYSTECTOMY IN GERIATRIC PATIENTS

Year 2021, Volume: 28 Issue: 3, 391 - 395, 13.09.2021
https://doi.org/10.17343/sdutfd.789171

Abstract

Objective
Since older patients are more likely to have
comorbidities, a major concern is that surgery in
geriatric patients carries an increased risk of morbidity
and mortality compared to younger patients. In
this study, it was aimed to compare the results of
laparoscopic cholecystectomy performed on patients
aged 18-64 and 65 and above, and to present these
results in light of the literature.
Material and Methods
Patients who underwent laparoscopic cholecystectomy
between January 2018 and December 2018 were retrospectively consecutively separated into two
groups: 40 patients between the ages of 18-64
were included in Group 1 while 40 patients aged 65
and above were included in Group 2. Demographic
features, surgical indications, hospitalization and
complication information of the patients were examined
and compared according to their file data.
Results
Eighty patients were included in the study. 18,8%
(n=15) of the patients were male while 81,2% (n=65)
were female. As an indication, chronic symptomatic
cholecystolithiasis was most prevalent in the group
below 65 years of age, whereas interval cholecystectomy
after subacute cholecystitis was more common in the
group aged 65 and above (p=0,012). Coronary artery
disease, chronic obstructive pulmonary disease, and
cardiac insufficiency were significantly more prevalent
in the group aged 65 years and above (p=0,014). No
difference was found between the groups in terms of
hospitalization durations and complications (p=0,933),
(p = 0,220).
Conclusion
Even though comorbidities are more commonly
observed in elderly patients, the fact that complications
and length of hospital stay are similar to the younger
group supports that laparoscopic cholecystectomy can
be performed safely in geriatric ages.

References

  • 1- Kuy S, Sosa JA, Roman SA, Desai R, Rosenthal RA. Age matters: a study of clinical and economic outcomes following cholecystectomy in elderly Americans. Am J Surg 2011;201(6):789-96.
  • 2- Mc Cleane G. Pain perception in the elderly patient. Clin Geriatr Med 2008;24(2):203-11.
  • 3- Erenoglu C, Öztürk A, Uluutku H, Kurt Y, Demirbaş S, Akın L ve ark. 70 Yaş Ve Üzerindeki Hastalarda Uygulanan Laparoskopik Kolesistektomi Sonuçları. End., Lap. ve Minimal İnvaziv Cerrahi 2003; 10(1-2): 36-40.
  • 4- Agrusa A, Romano G, Frazzetta G, Chianetta D, Sorce V, DiBuono G, et al. Role andoutcomes of laparoscopic cholecystectomy in the elderly.Int J Surg 2014;12 (Suppl) 2:37-39.
  • 5- Bettelli G. Preoperative evaluation in geriatric surgery: comorbidity, functional status and pharmacological history. Minerva Anestesiol 2011;77(6):637-46.
  • 6- Gologan E, Balan G, Stanciu C. Conventional ultrasound in the diagnosis of bile duct calculi. Rev Med Chir Soc Med Nat Iasi 2006;110:824-29.
  • 7- Yeh BM, Liu PS, Soto JA, Corvera CA, Hussain HK. MR imaging and CT of the biliary tract. Radiographics 2009;29(6):1669-88.
  • 8- Akyüz C, Sunamak O. Comparison of emergency and elective laparoscopic cholecystectomy in geriatric patients. Clin Exp Health Sci 2017;7:91-93.
  • 9- Martinez JP, Mattu A. Abdominal pain in the elderly. Emerg Med Clin North Am 2006;24(2):371-88.
  • 10-Berggren U, Gordh T, Grama D, Haglund U, Rastad J, Arvidsson D. Laparoscopic versus open cholecystectomy: hospitalization, sick leave, analgesia and trau-ma responses. Br J Surg 1994 (Sep);81(9):1362-65.
  • 11- Dubecz A, Langer M, Stadlhuber RJ, Schweigert M, Solymosi N, Feith M, et al. Cholecystectomy in the very elderly-is 90 the new 70? J Gastrointest Surg 2012;16(2):282-85.
  • 12- Bhandari TR , Shahi S, Bhandari R, Poudel R. Laparoscopic cholecystectomy in the elderly: an experience at a tertiary care hospital in western Nepal. Surg Res Pract 2017;8204578. Epub 2017 May 10, doi: 10.1155/2017/8204578.
  • 13- Özkan E, Yıldız MK, Çakır T, Günay E, Eriş C, Dulundu E ve ark. Yaşı 65 ve daha üzerinde olan hastalarda laparoskopik kolesistektominin analiz sonuçları. Ulus Cerrahi Derg 2012; 28(2): 88-91.

YAŞLI HASTALARDA LAPAROSKOPİK KOLESİSTEKTOMİNİN FARKLILIKLARI VE GÜVENİLİRLİĞİ

Year 2021, Volume: 28 Issue: 3, 391 - 395, 13.09.2021
https://doi.org/10.17343/sdutfd.789171

Abstract

Yaşlılarda ek hastalıkların daha fazla olmasından dolayı,
yapılacak cerrahi işlemlerde morbidite ve mortalite
riskinin gençlere kıyasla daha fazla olabileceği endişesi
hakimdir. Bu çalışmada, 18-64 yaş arası hastalar
ile 65 yaş ve üstü hastalarda uygulanan laparoskopik
kolesistektominin sonuçları karşılaştırılarak literatür
eşliğinde sunulması amaçlanmıştır.
Gereç ve Yöntem
Ocak 2018- Aralık 2018 tarihleri arasında laparoskopik
kolesistektomi uygulanan hastalar retrospektif ardışık
olarak 18-64 yaş arası 40 hasta grup 1, 65 yaş ve üstü
40 hasta grup 2 olarak iki gruba ayrıldı. Hastaların dosya
verilerine göre demografik özellikleri, ameliyat endikasyonu,
yatış ve komplikasyon bilgileri incelenerek
karşılaştırıldı.
Bulgular
Çalışmaya 80 hasta dahil edildi. Hastaların %18,8’si
(15) erkek, %81,2’i (65) ise kadın idi. Endikasyon olarak
65 yaş altı grupta kronik semptomlu kolelisistolitiazis
ön planda iken, 65 yaş ve üstü grupta subakut
kolesistit sonrası interval kolesistektominin daha fazla
olduğu görüldü (p=0,012). 65 yaş ve üstü grupta koroner
arter hastalığı, kronik obstrüktif akciğer hastalığı
ve kalp yetmezliğinin anlamlı olarak daha fazla olduğu
görüldü (p=0,014). Hastanede kalış süreleri ve komplikasyonlar
açısından gruplar arasında fark tespit edilmedi
(p=0,933), (p=0,22).
Sonuç
Ek hastalıklar yaşlı hastalarda daha sık izlenmesine
rağmen, komplikasyon ve hastanede kalış sürelerinin
genç grupla benzer olması, geriatrik yaşlarda da laparoskopik
kolesistektominin güvenle yapılabileceğini
desteklemektedir.

References

  • 1- Kuy S, Sosa JA, Roman SA, Desai R, Rosenthal RA. Age matters: a study of clinical and economic outcomes following cholecystectomy in elderly Americans. Am J Surg 2011;201(6):789-96.
  • 2- Mc Cleane G. Pain perception in the elderly patient. Clin Geriatr Med 2008;24(2):203-11.
  • 3- Erenoglu C, Öztürk A, Uluutku H, Kurt Y, Demirbaş S, Akın L ve ark. 70 Yaş Ve Üzerindeki Hastalarda Uygulanan Laparoskopik Kolesistektomi Sonuçları. End., Lap. ve Minimal İnvaziv Cerrahi 2003; 10(1-2): 36-40.
  • 4- Agrusa A, Romano G, Frazzetta G, Chianetta D, Sorce V, DiBuono G, et al. Role andoutcomes of laparoscopic cholecystectomy in the elderly.Int J Surg 2014;12 (Suppl) 2:37-39.
  • 5- Bettelli G. Preoperative evaluation in geriatric surgery: comorbidity, functional status and pharmacological history. Minerva Anestesiol 2011;77(6):637-46.
  • 6- Gologan E, Balan G, Stanciu C. Conventional ultrasound in the diagnosis of bile duct calculi. Rev Med Chir Soc Med Nat Iasi 2006;110:824-29.
  • 7- Yeh BM, Liu PS, Soto JA, Corvera CA, Hussain HK. MR imaging and CT of the biliary tract. Radiographics 2009;29(6):1669-88.
  • 8- Akyüz C, Sunamak O. Comparison of emergency and elective laparoscopic cholecystectomy in geriatric patients. Clin Exp Health Sci 2017;7:91-93.
  • 9- Martinez JP, Mattu A. Abdominal pain in the elderly. Emerg Med Clin North Am 2006;24(2):371-88.
  • 10-Berggren U, Gordh T, Grama D, Haglund U, Rastad J, Arvidsson D. Laparoscopic versus open cholecystectomy: hospitalization, sick leave, analgesia and trau-ma responses. Br J Surg 1994 (Sep);81(9):1362-65.
  • 11- Dubecz A, Langer M, Stadlhuber RJ, Schweigert M, Solymosi N, Feith M, et al. Cholecystectomy in the very elderly-is 90 the new 70? J Gastrointest Surg 2012;16(2):282-85.
  • 12- Bhandari TR , Shahi S, Bhandari R, Poudel R. Laparoscopic cholecystectomy in the elderly: an experience at a tertiary care hospital in western Nepal. Surg Res Pract 2017;8204578. Epub 2017 May 10, doi: 10.1155/2017/8204578.
  • 13- Özkan E, Yıldız MK, Çakır T, Günay E, Eriş C, Dulundu E ve ark. Yaşı 65 ve daha üzerinde olan hastalarda laparoskopik kolesistektominin analiz sonuçları. Ulus Cerrahi Derg 2012; 28(2): 88-91.
There are 13 citations in total.

Details

Primary Language Turkish
Subjects Surgery
Journal Section Research Articles
Authors

Ahmet Türkan 0000-0002-3065-5273

Ahmet Erdoğan 0000-0002-0126-4679

Uğur Kılınç 0000-0003-4573-4115

Publication Date September 13, 2021
Submission Date September 1, 2020
Acceptance Date August 9, 2021
Published in Issue Year 2021 Volume: 28 Issue: 3

Cite

Vancouver Türkan A, Erdoğan A, Kılınç U. YAŞLI HASTALARDA LAPAROSKOPİK KOLESİSTEKTOMİNİN FARKLILIKLARI VE GÜVENİLİRLİĞİ. Med J SDU. 2021;28(3):391-5.

                                                                                               14791 


Süleyman Demirel Üniversitesi Tıp Fakültesi Dergisi/Medical Journal of Süleyman Demirel University is licensed under Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International.