Laparoscopic Cholecystectomy in Patients Over 80 years is Feasible and Safe: Analysis of 68 Consecutive Cases

the population over 80 years old undergoing laparoscopic cholecystectomy may have morbidity rates of 2.2-24% and mortality rates of up to 2.8%.3-7 The potential benefits of laparoscopic surgery may be lost if conversion to an open operation is necessary. If not unduly delayed, conversion carries similar risks to open cholecystectomy, whereas ‘enforced’ conversion usually following severe iatrogenic injury or bleeding is associated with higher morbidity and mortality.8 Patients over 80 years generally have higher conversion rates of 2.2-37%,3-5,9-11 the most significant factor being the increased incidence of complex pathologies related to gallstones. The incidences of acute and chronic cholecystitis, severe scarring and adhesions, common bile duct stones, gallstone pancreatitis, previous upper abdominal surgery and gallbladder cancers are all increased in the elderly population.5,6,12 This paper reports the experience of a district general hospital unit in the management of gallstone disease in a population over 80 years old.