SURGERY FOR GALLSTONES IN THE ELDERLY

In a consecutive series of 349 patients undergoing surgery for gallstones, 66 patients (19%) were aged over 65 years. Within this group of elderly patients, 51 underwent laparoscopic cholecystectomy which was successful in 84% of cases. The most frequent cause for conversion to open surgery was the presence of dense pericystic adhesions. Fifteen patients (23%) underwent elective open surgery. The principal reason was co-existent duct stones. There was no operative mortality and procedure related morbidity in the elderly following laparoscopic or open surgery was similar. Laparoscopic cholecystectomy can be safely and effectively performed in the majority of elderly patients, offering them the perceived advantages of this technique. However, the presence of duct stones in 18% of cases necessitates careful evaluation of these patients pre-operatively.