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Safety of laparoscopic cholecystectomy in patients older than 90 years in a private hospital in ecuador: A case series

Abstract:

Background: The rate of biliary lithiasis and its complications are higher in the elderly. Some authors describe age as the main factor that significantly increases the morbidity and mortality of patients undergoing cholecystectomy. Objective: The objective of this study was to describe the safety of laparoscopic cholecystectomy, focusing on complication and conversion rates in patients older than 90 years, in a private hospital of a developing country. Materials and methods: This case-series enrolled patients older than 90 years diagnosed with acute cholecystitis using the Tokyo 2013 criteria. All included patients underwent laparoscopic cholecystectomy from January 2010 to December 2016 at Vozandes Hospital Quito-Ecuador. Frequencies and percentages and mean were reported for categorical and numerical variables, respectively. Results: We included 15 patients aged between 90 and 96 years. There were three post-operative complications, two cases of hypovolemic shock secondary to bleeding that stop without reoperation (13%) and 1 of delirium (7%). Conversion was performed in two patients (13%) due to the impossibility of visualizing the anatomical structures and obtain an adequate critical view of safety due to gallbladder phlegmon. Conclusion: Laparoscopic cholecystectomy seems to be a safe approach, with relatively low complication and conversion rates in patients older than 90 years.