Comparison between open and laparoscopic elective cholecystectomy in elderly, in a teaching hospital

Abstract

Background: With increasing life expectancy and advancements in healthcare, elderly individuals are undergoing elective cholecystectomy procedures for gallstones. This study aims to compare open cholecystectomy (OC) and laparoscopic cholecystectomy (LC) in elderly patients, considering factors like conversion rates, hospital stay, and surgical duration. Methods: A retrospective analysis of 120 medical records of patients aged 65 or older who underwent elective cholecystectomy at a teaching hospital was conducted. Patients with emergency cases or intraoperative cholangiography were excluded. Data included age, gender, cardiovascular risk, surgery duration, complications, and hospital stay. Statistical tests were used for comparisons.
Results: Of the 120 patients, 38.3% had OC, and 61.7% had LC. The mean age was 70.1 years. Two patients (4.3%) in OC and two (2.7%) in LC required conversion to open surgery. Hospital stay was shorter for LC (2.01 days) compared to OC (2.95 days), with similar surgery durations (84 minutes). Complications occurred in 14.3% of OC and 12.2% of LC cases. Recommendations: Based on the study findings, we recommend elective laparoscopic cholecystectomy (LC) as a preferred option for elderly patients with gallstones. LC offers
advantages over open cholecystectomy (OC), including shorter hospital stays and similar  surgical outcomes. Encourage healthcare providers to consider LC for eligible elderly patients to enhance recovery. Further research in diverse healthcare settings is needed to validate these findings and provide comprehensive guidelines for managing gallstone-related procedures in the elderly.
Conclusion: Elective LC is a safe and effective option for elderly patients with symptomatic gallstones. It offers shorter hospital stays and comparable surgical outcomes to OC, making it a viable choice for this demographic