Laparoscopic cholecystectomy is safe but underused in the elderly

James J. Tucker, Franz Yanagawa, Rod Grim, Theodore Bell, Vanita Ahuja

Research output: Contribution to journalArticle

Abstract

Studies confirm that laparoscopic cholecystectomy (LC) is safe and efficacious for elderly patients. The purposes of this study were to evaluate if LC is underused in the elderly and if it is a safe option in that group. Open cholecystectomy (OC) and LC were compared in nonelderly (40 to 64 years) and elderly (65 years or older) matched patient groups identified with gallbladder disease using the American College of Surgeons National Surgical Quality Improvement Program database (2005 to 2008). Length of stay (LOS), 30-day complications, and mortality were evaluated as outcomes. Using multivariate logistic regression, independent predictors of OC were identified. After case-matching, each group had 11,926 patients.Ax2 test showed that elderly (20.1 vs 15.0%, P<0.001) were more likely to undergo OC. Elderly patients had significantly higher comorbidities and were operated on as emergent case (all P<0.05).OC had longer LOS and mortality (all P<0.05). Among 10 other variables in logistic regression, elderly had a higher likelihood of receiving OC (OR, 1.299; P<0 0.001). Significant disparity exists between elderly and nonelderly patients in use of LC surgery. LC has a lower complication rate than OC; however, elderly undergo LC less often. Awareness needs to be raised for offering earlier operative intervention and the superior results of LC in the elderly.

Original languageEnglish (US)
Pages (from-to)1014-1020
Number of pages7
JournalAmerican Surgeon
Volume77
Issue number8
Publication statusPublished - Aug 2011
Externally publishedYes

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ASJC Scopus subject areas

  • Surgery

Cite this

Tucker, J. J., Yanagawa, F., Grim, R., Bell, T., & Ahuja, V. (2011). Laparoscopic cholecystectomy is safe but underused in the elderly. American Surgeon, 77(8), 1014-1020.