Acute Cholecystitis in Very Elderly Patients: Disease Management, Outcomes, and Risk Factors for Complications.
Journal
Surgery research and practice
ISSN: 2356-7759
Titre abrégé: Surg Res Pract
Pays: United States
ID NLM: 101628730
Informations de publication
Date de publication:
2019
2019
Historique:
received:
19
11
2018
accepted:
06
01
2019
entrez:
12
3
2019
pubmed:
12
3
2019
medline:
12
3
2019
Statut:
epublish
Résumé
The aim of this study was to evaluate the characteristics, management, and outcomes of acute cholecystitis in patients ≥80 years. This was a retrospective analysis of data from a prospective single-center patient registry. The study population was composed of 348 patients, which were divided into two groups: those younger (Group A) and those older (Group B) than the median age (85.4 years). Although demographic and clinical characteristics of the two groups were similar, the disease management was clearly different, with older patients undergoing cholecystectomy less frequently ( In elderly patients with AC, the choice of therapeutic options was not limited by the age per se, but rather by the disease severity (grade III AC) and/or poor physical status (ASA III-IV). In case of grade I-II AC, laparoscopic cholecystectomy can be safely performed and yield good results even in very old patients. Patients with grade III AC present high risk of morbidity and mortality, and the treatment should be individualized. ASA IV patients should avoid cholecystectomy, being antibiotic treatment and cholecystectomy the best option.
Sections du résumé
BACKGROUND
BACKGROUND
The aim of this study was to evaluate the characteristics, management, and outcomes of acute cholecystitis in patients ≥80 years.
METHODS
METHODS
This was a retrospective analysis of data from a prospective single-center patient registry.
RESULTS
RESULTS
The study population was composed of 348 patients, which were divided into two groups: those younger (Group A) and those older (Group B) than the median age (85.4 years). Although demographic and clinical characteristics of the two groups were similar, the disease management was clearly different, with older patients undergoing cholecystectomy less frequently (
CONCLUSIONS
CONCLUSIONS
In elderly patients with AC, the choice of therapeutic options was not limited by the age per se, but rather by the disease severity (grade III AC) and/or poor physical status (ASA III-IV). In case of grade I-II AC, laparoscopic cholecystectomy can be safely performed and yield good results even in very old patients. Patients with grade III AC present high risk of morbidity and mortality, and the treatment should be individualized. ASA IV patients should avoid cholecystectomy, being antibiotic treatment and cholecystectomy the best option.
Identifiants
pubmed: 30854417
doi: 10.1155/2019/9709242
pmc: PMC6378058
doi:
Types de publication
Journal Article
Langues
eng
Pagination
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