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The safety of a laparoscopic cholecystectomy in acute cholecystitis in high-risk patients older than sixty with stratification based on ASA score

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Authors
Yi, Nam-Joon; Han, Ho-Seong; Min, Seog-Ki
Issue Date
2006-06-21
Publisher
Taylor & Francis
Citation
Minim Invasive Ther Allied Technol. 2006;15(3):159-64
Keywords
Age FactorsAged*AnesthesiaCholecystectomy, Laparoscopic/*adverse effects/mortalityCholecystitis, Acute/*surgeryFemaleHumansLength of StayMaleMiddle AgedRetrospective StudiesRisk AssessmentTreatment Outcome
Abstract
The purpose of this study was to evaluate the safety of a laparoscopic cholecystectomy (LC) for acute cholecystitis (AC) in patients older than sixty years of age, with stratification based on the ASA (American Society of Anesthesiologists) score. For five years, 137 patients older than sixty, who had undergone a LC for AC, were classified into three groups; ASA 1 (n = 33), ASA 2 (n = 79) and ASA 3 (n = 25). Preoperative percutaneous gallbladder drainage was performed in eight of the 137 cases (5.8%). All except one underwent one-stage management and 19.7% patients underwent emergency surgery within 24 hours of the index admission of AC. The preoperative hospital stay for ASA 3 (8.8 days) was longer than that for ASA 1 (5.6 days). There was a higher proportion of complicated cholecystitis and a longer operating time in ASA 2 (50.6%, 111 min.) and 3 (66.7 %, 114 min.) than in ASA 1 (24.2%, 85 min.) (p<0.05). Morbidity was more frequent in ASA 3 (20.0%) than in ASA 1 (9.1%). However, the open conversion rate, time to diet, and postoperative hospital stay were similar in the three groups (p>0.05). We conclude that a LC for AC may be an effective treatment option in elderly-high risk patients.
ISSN
1364-5706 (Print)
Language
English
URI
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=16785182

http://hdl.handle.net/10371/15698
DOI
https://doi.org/10.1080/13645700600760044
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College of Medicine/School of Medicine (의과대학/대학원)Surgery (외과학전공)Journal Papers (저널논문_외과학전공)
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