TY - JOUR
T1 - The safety of a laparoscopic cholecystectomy in acute cholecystitis in high-risk patients older than sixty with stratification based on ASA score
AU - Yi, Nam Joon
AU - Han, Ho Seong
AU - Min, Seog Ki
PY - 2006/6
Y1 - 2006/6
N2 - The purpose of this study was to evaluate the safety of a laparoscopic cholecystectomy (LC) for acute cholecystitis (AC) in patients older than sixty years of age, with stratification based on the ASA (American Society of Anesthesiologists) score. For five years, 137 patients older than sixty, who had undergone a LC for AC, were classified into three groups; ASA 1 (n = 33), ASA 2 (n = 79) and ASA 3 (n = 25). Preoperative percutaneous gallbladder drainage was performed in eight of the 137 cases (5.8%). All except one underwent one-stage management and 19.7% patients underwent emergency surgery within 24 hours of the index admission of AC. The preoperative hospital stay for ASA 3 (8.8 days) was longer than that for ASA 1 (5.6 days). There was a higher proportion of complicated cholecystitis and a longer operating time in ASA 2 (50.6%, 111 min.) and 3 (66.7 %, 114 min.) than in ASA 1 (24.2%, 85 min.) (p < 0.05). Morbidity was more frequent in ASA 3 (20.0%) than in ASA 1 (9.1%). However, the open conversion rate, time to diet, and postoperative hospital stay were similar in the three groups (p > 0.05). We conclude that a LC for AC may be an effective treatment option in elderly-high risk patients.
AB - The purpose of this study was to evaluate the safety of a laparoscopic cholecystectomy (LC) for acute cholecystitis (AC) in patients older than sixty years of age, with stratification based on the ASA (American Society of Anesthesiologists) score. For five years, 137 patients older than sixty, who had undergone a LC for AC, were classified into three groups; ASA 1 (n = 33), ASA 2 (n = 79) and ASA 3 (n = 25). Preoperative percutaneous gallbladder drainage was performed in eight of the 137 cases (5.8%). All except one underwent one-stage management and 19.7% patients underwent emergency surgery within 24 hours of the index admission of AC. The preoperative hospital stay for ASA 3 (8.8 days) was longer than that for ASA 1 (5.6 days). There was a higher proportion of complicated cholecystitis and a longer operating time in ASA 2 (50.6%, 111 min.) and 3 (66.7 %, 114 min.) than in ASA 1 (24.2%, 85 min.) (p < 0.05). Morbidity was more frequent in ASA 3 (20.0%) than in ASA 1 (9.1%). However, the open conversion rate, time to diet, and postoperative hospital stay were similar in the three groups (p > 0.05). We conclude that a LC for AC may be an effective treatment option in elderly-high risk patients.
KW - Acute cholecystitis
KW - American Society of Anesthesiologists (ASA) score
KW - High risk patients
KW - Laparoscopic cholecystectomy
UR - http://www.scopus.com/inward/record.url?scp=33745327617&partnerID=8YFLogxK
U2 - 10.1080/13645700600760044
DO - 10.1080/13645700600760044
M3 - Article
C2 - 16785182
AN - SCOPUS:33745327617
SN - 1364-5706
VL - 15
SP - 159
EP - 164
JO - Minimally Invasive Therapy and Allied Technologies
JF - Minimally Invasive Therapy and Allied Technologies
IS - 3
ER -