Early versus delayed same-admission laparoscopic cholecystectomy for acute cholecystitis in elderly patients with comorbidities

The Journal of Trauma and Acute Care Surgery
Tobias HaltmeierDemetrios Demetriades

Abstract

The optimal timing of same-admission laparoscopic cholecystectomy (LC) for acute cholecystitis (AC) in elderly patients, especially those with significant comorbidities, is not clear. This is a National Surgical Quality Improvement Program study, which included patients older than 65 years undergoing LC for AC. Patients with choledocholithiasis were excluded. Patients were divided into two subgroups as follows: no significant comorbidities (American Society of Anesthesiologists [ASA] score ≤ 2) and significant comorbidities (ASA score > 2). Patients undergoing LC within 24 hours of admission (early LC) were compared with patients undergoing LC later than 24 hours after admission (delayed LC), using univariable and multivariable regression analyses. A total of 4,011 patients were included in the study. Early LC was performed in 38.0% and delayed LC in 62.0% of the patients. Regression analysis identified early LC as an independent predictor for shorter anesthesia time and postoperative length of stay, overall and in the subgroup with an ASA score greater than 2. Early, within 24 hours of admission, LC for AC in patients older than 65 years with significant comorbidities is associated with shorter postoperative stay and no increa...Continue Reading

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Citations

Jul 10, 2016·Clinics in Geriatric Medicine·Ana Berlin, Jason Michael Johanning
Jun 17, 2016·World Journal of Emergency Surgery : WJES·L AnsaloniE E Moore
Nov 3, 2016·HPB Surgery : a World Journal of Hepatic, Pancreatic and Biliary Surgery·Miguel Sánchez-CarrascoF Javier Sánchez-Manuel
Apr 22, 2017·World Journal of Gastroenterology : WJG·Zong-Ming ZhangYue Zhao
Oct 21, 2015·World Journal of Hepatology·Purvi P PatelJose M Velasco
Mar 12, 2019·Surgery Research and Practice·Alfredo EscartínJorge-Juan Olsina
Dec 4, 2020·Revista Española De Enfermedades Digestivas : Organo Oficial De La Sociedad Española De Patología Digestiva·Jaume Tur-MartínezJorge Juan Olsina

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