Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “CHOLECYSTECTOMY”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 577 records · Page 32Linked to original sources
PubMed2002

Incidental cholecystectomy during laparoscopic antireflux surgery.

Cholelithiasis and gastroesophageal reflux are both very common diseases that may occur simultaneously. Management of asymptomatic gallstones is still controversial. Because severe complications due to gallstones may occur incidental cholecystectomy during nonrelated abdominal surgery may be offered to patients with coexisting gallbladder disease. The aim of this study was to assess the clinical outcome of patients after laparoscopic fundoplication and incidental cholecystectomy for cholelithiasis compared with the outcome of patients after fundoplication alone. We conducted a retrospective chart review and prospective analysis using a questionnaire of the clinical outcome of patients who underwent laparoscopic fundoplication and incidental cholecystectomy from June 1991 to January 2000 in comparison with sex- and age-matched patients who had antireflux surgery alone. Sixty-seven (6.3%) of 1065 patients had a laparoscopic cholecystectomy at the time of laparoscopic antireflux surgery; 101 (75%) of 134 answered the questionnaire. The mean follow-up time was 4.6 years. Laparoscopic cholecystectomy did not influence surgical morbidity or mortality. Postoperative symptom score (1-10) did not show a statistically significant difference regarding bloating, diarrhea, abdominal pain, nausea, vomiting, biliary problems, jaundice, pancreatitis, dysphagia for liquids and solid, heartburn, regurgitation, and chest pain when the two groups were compared. We conclude that incidental cholecystectomy during laparoscopic antireflux surgery is safe and does not appear to influence the clinical outcome of the antireflux procedure.

Blood Loss, Surgical↗
PubMed2000

Does the laparoscopic cholecystectomy accelerate the intraperitoneal dissemination of previously unrecognized gallbladder cancer.

BACKGROUND: Many observations suggest that early intraperitoneal dissemination and port site metastasis occur after laparoscopic cholecystectomy in previously unrecognized gallbladder cancer. MATERIAL AND METHODS: In the years 1992-1999 nine patients after laparoscopic cholecystectomy, were operated on because of previously unsuspected gallbladder cancer following standard postoperative microscopic examination. All gallbladders with markedly thickened wall were removed from abdominal cavity in protective bag. In three cases tumor infiltrated muscular layer (T1b), and in six serosa (T3). All patients 12 to 65 days after cholecystectomy were operated in order to extended operational margins. RESULTS: In four cases (three T1, one T3) during the second operation 3 cm width of the liver parenchyma surrounding the gallbladder bed was resected, along the dissection of the lymphatic of the hepatoduodenal ligament. In these four patients no neoplastic infiltration was found on microscopic examination. All four patients are alive with no signs of recurrence within 3, 5, 17 and 40 months after cholecystectomy. In five persons (all T3), at the second operation, we found intraperitoneal carcinomatosis, and operation was limited to only explorative laparotomy. Four of these five patients died 3, 4, 10 and 11 months after cholecystectomy. One patient is alive 22 months after operation; in this case microscopic examination did not confirm the macroscopic intraoperative diagnosis. CONCLUSION: Laparoscopic cholecystectomy probably accelerates intraperitoneal dissemination in previously unrecognized gallbladder cancer, especially in stage T3 patients and contemporary standard precautions are inadequate.

Aged↗
PubMed2001

A prognostic index of unsuccessful laparoscopic cholecystectomy for acute calculous cholecystitis.

The aim of this retrospective study was to investigate the accuracy of using preoperative data for the prediction of conversion from laparoscopic to open cholecystectomy in patients operated on for acute calculous cholecystitis. Laparoscopic cholecystectomy was scheduled in eighty-nine of 184 consecutive patients with acute calculous cholecystitis who underwent urgent or early cholecystectomy without bile duct exploration in our department between 1991 and 1998. The correlation between 11 preoperative clinical, laboratory and ultrasonographic variables, and the rate of conversion to open cholecystectomy was studied. Among the 11 variables tested, age and leukocyte count were independent factors of predictive significance. These two factors were used for constructing an additive prognostic index for conversion to open cholecystectomy. Thus, three groups of patients could be identified having a 10%, 30-70% or over 88% risk of conversion. Logistic regression analysis permits accurate preoperative identification of unsuccessful laparoscopic cholecystectomy in patients with acute calculous cholecystitis.

Age Distribution↗
PubMedDate not supplied

Laparoscopic cholecystectomy: a report on 2000 cases.

BACKGROUND/AIMS: This is a retrospective study to evaluate the results of laparoscopic cholecystectomy after 2000 cases at a single center. METHODOLOGY: Between June 1992 and February 2000, 2000 patients (1458 females and 542 males, mean age 39.8 years) with symptomatic gallstones underwent laparoscopic cholecystectomy. All cases were diagnosed by abdominal ultrasonography. Preoperative endoscopic retrograde cholangiopancreatography was done for 31 patients. Four trocars were used for all except 20 cases. RESULTS: The mean operative time was 45 +/- 15 minutes. Conversion to open cholecystectomy occurred in 147 patients (7.35%). Adhesions were the commonest cause of conversion (2.9%). There was no technique-related mortality. Bile duct injury occurred in 7 cases (0.35%), reconstruction by Rouxen-Y hepaticojejunostomy was necessary in 5 cases and the injury was successfully managed by endoscopic stent in 2 cases. Bile leakage occurred in 11 cases (0.55%), peritonitis in 5 cases (0.25%), internal hemorrhage in 9 cases (0.45%), cystic artery injury in 17 cases (0.85%), pneumothorax in one case (0.05%) and subcutaneous emphysema in 3 cases (0.15%). CONCLUSIONS: Laparoscopic cholecystectomy is a good alternative to open cholecystectomy with an acceptable morbidity. Conversion to open cholecystectomy at the proper time will prevent major complications.

Adolescent↗
PubMedDate not supplied

Regional differences in appropriateness of cholecystectomy in a prepaid health insurance system.

BACKGROUND: Previous studies have reported variation in the population-based use rate of diagnostic and therapeutic procedures. Cholecystectomy is one of the most common surgical procedures, and we conducted this study to assess whether in Israel the use of this procedure varied by region and whether differences in use can be related to differences in appropriateness of use. In Israel, there is a pre-paid health insurance system and all surgeons are salaried. METHODS: Age-adjusted rates of cholecystectomy in four hospitals, each serving a defined population in Israel, were calculated. Two hundred and sixty-six potential clinical indications for performing cholecystectomy were rated as to their appropriateness by a panel of 9 expert physicians. A trained team abstracted the medical records of all patients who underwent the operation in the four Israeli hospitals in 1986 (n = 702) and recorded the clinical indication for the surgery. RESULTS: The population-based age-adjusted rates of cholecystectomy varied over threefold among the four hospitals. 29% of the cholecystectomies were performed for less than appropriate reasons, and this figure varied by hospital from 36% to 17% (p = 0.002). However, appropriateness did not vary systematically with the population-based use rate. CONCLUSION: Cholecystectomy was performed frequently for inappropriate or equivocal reasons, even in a country in which resources are limited, and physicians are salaried. Efforts to improve surgical decision making should be undertaken.

Adult↗
PubMed1992

[Laparoscopic cholecystectomy: experience of VGH-Kaohsiung].

One hundred consecutive patients underwent laparoscopic cholecystectomy from May 1991 to February 1992 at Veterans General Hospital--Kaohsiung. Ninety-seven of them presented on an elective basis, including eight patients undergoing endoscopic sphincterotomy with extraction of common bile duct stone before laparoscopic cholecystectomy. The remaining 3 patients were operated during acute cholecystitis episode. Two patients with biliary injuries during laparoscopic cholecystectomy were converted to laparotomy, with a conversion rate of 2%. Intraoperative cystic cholangiogram was done selectively in 7 patients. Major complications occurred in 3 patients, including two biliary injuries and one residual CBD stone. Minor complications of wound infection were found in 7 patients. The overall morbidity rate was 10%. No operative mortality was found. Mean operation time was 112 minutes and mean blood loss was 90 ml. The mean hospital stay (3.1 days) and the mean time of returning to normal activity (14.7 days) were longer than those of Western series, but were shorter than those of open cholecystectomy. Laparoscopic cholecystectomy is a safe and effective procedure that can be performed with minimal risk. However, the importance of accurate preoperative screening and surgical experience should be emphasized for this new procedure. In patients with gall stone plus CBD stone, combined endoscopic sphincterotomy with extraction of CBD stone and laparoscopic cholecystectomy may offer a new therapeutic approach but the long term effect of endoscopic sphincterotomy needs further evaluation.

Adult↗
PubMed1992

Pulmonary changes after laparoscopic cholecystectomy.

Laparoscopic cholecystectomy has become a widely used procedure. Upper abdominal surgery and particularly open cholecystectomy are known to be associated with marked declines in lung volume and a high risk of postoperative pulmonary complications. The pulmonary effects of laparoscopic cholecystectomy have not yet been studied. We prospectively evaluated 22 patients admitted for laparoscopic cholecystectomy for lung volume changes and development of postoperative pulmonary complications. The procedure was associated with a marked decline in forced vital capacity (FVC, 41.2 +/- 20.7%) and forced expiratory volume in one second (FEV1, 41.4 +/- 20.8%) in the immediate postoperative period. There was no significant difference in loss of lung function according to age (p = 0.18), sex (p = 0.33), or smoking history (p = 0.58). Despite the marked loss in lung function in the immediate postoperative period, no major pulmonary complications occurred. We conclude that laparoscopic cholecystectomy, although associated with early loss of lung function, is a safe and effective procedure with an incidence of postoperative pulmonary complications much less than with open cholecystectomy.

Adult↗
PubMed1992

Relationship of cholecystectomy and detachment of the common bile duct to chronic bile duct dilation.

A combination of a cholecystectomy and detachment of the supportive tissue surrounding the extrahepatic bile duct results in chronic bile duct dilation. To clarify whether this cholangiectasis is due to the detachment of the surrounding tissue or to the cholecystectomy, we have studied 4 groups of adult mongrel dogs, i.e., a control group given a sham operation (n = 20), a group given cholecystectomy (n = 20), a group that had the surrounding tissue detached from the bile duct (n = 20), and a group given both a cholecystectomy and detachment of the surrounding tissue (n = 29). On examination by cholangiography at 1, 2, 3, and 4 weeks after the initial laparotomy, no significant cholangiectasis was found in dogs subjected to either cholecystectomy alone or to detachment of the surrounding tissue alone. In contrast, in dogs subjected to a cholecystectomy combined with detachment of the bile duct, the bile duct gradually dilated, resulting in significant cholangiectasis at 4 weeks. However, the intrabiliary pressure, the residual pressure, and the actual resistance value, which are indices of a passage disturbance in the sphincter of Oddi, were normal in all 4 groups. It is therefore concluded that both the extirpation of the gallbladder, and the lack of supportive tissue surrounding the bile duct were responsible for the resulting cholangiectasis.

Animals↗
PubMedDate not supplied

[Male gender-- difficulty factor in cholecystectomies for cholelithiasis].

Male gender has been recognized as a risk factor for an increased conversion rate of laparoscopic cholecystectomy and more severe disease in those with symptomatic cholelithiasis. The aim of this study was to determine the effect of male gender on the clinical presentation of symptomatic cholelithiasis, relation between male gender and acute cholecystectes, the operating time, the frequency of conversion and postoperative morbidity. The medical records of all patients with symptomatic cholelithiasis from 31 mars 1993 to 31 mars 2001 (4145 patients) were evaluated. These cases were divided into four groups: A--elective laparoscopic cholecystectomy group--patients with cholecystectes with elective laparoscopic cholecystectomy (3995 cases); B--patients with acute cholecystectes whose laparoscopic cholecystectomy was performed successfully (660 cases); C--acute conversion group converted to open surgery (240 cases); D--acute open group with elective open cholecystectomy. The study reveals that males suffer from a severe form of cholecystectes that raise difficulties when laparoscopic cholecystectomy is performed.

Adolescent↗
PubMedDate not supplied

Efficacy of laparoscopic cholecystectomy in acalculous gallbladder disease: long-term follow-up.

OBJECTIVE: Our aim was to determine the efficacy of laparoscopic cholecystectomy in symptomatic patients with ultrasound negative and abnormal gallbladder ejection fractions; Patients with gallbladder ejection fractions less than 35% on hepatobiliary scan were offered laparoscopic cholecystectomy. METHODS: Between January 1995 and January 2001, 1564 patients underwent laparoscopic cholecystectomy at our institution: 256 were confirmed to have acalculous gallbladder disease by pathology report and reconfirmation of abnormal hepatobiliary scan data. A 30-day postoperative follow-up was obtained by retrospective medical record review. For this study, we contacted all 256 patients by mail questionnaire and followed up on nonresponders with telephone interviews; we also reviewed hospital records to verify preoperative symptom patterns. The survey was completed by 154 patients (60%): 48 (31%) by mail and 106 (69%) by telephone interviews. The study included 115 (75%) female and 39 (25%) male patients, and the average age was 42 years (range, 13 to 95). All hepatobiliary laboratory parameters were normal pre- and postoperatively. The survey was completed in December 2001, 1 to 5 years postoperatively (mean 3 years). RESULTS: Preoperatively, 142 patients (92%) had right upper quadrant pain, 114 (74%) had nausea, 88 (57%) had vomiting, 120 (73%) had heartburn, and 118 (77%) had food intolerance. In a 30-day postoperative period, these numbers had reduced to 48 (37%), 14 (90%), 8 (5%), 22 (14%), and 34 (22%), respectively. had laparoscopic cholecystectomy, and 95% stated that they would recommend laparoscopic cholecystectomy to other patients. CONCLUSION: This study shows that patients with acalculous gallbladder disease benefit from laparoscopic cholecystectomy.

Acalculous Cholecystitis↗
PubMed1992

Increased incidence of gallstones and prior cholecystectomy in patients with large bowel cancer.

In a retrospective study, the frequency of occurrence of gallstones and cholecystectomy in 479 patients with colorectal cancer was compared with that of 483 matched control patients with other malignancies. The mean interval between cholecystectomy and colon cancer diagnosis was 15.1 +/- 9.9 yr (range 2-53 yr), and there was no statistically significant difference, compared with the control group at 13.9 +/- 8.2 yr (range 2-31 yr). In patients with colon cancer, the general increased relative risk of concomitant diagnosed gallstones (relative risk 1.73, p = 0.0123) and the relative risk of cholecystectomy (relative risk 2.08, p = 0.0074) was statistically significant. However, when the data with regard to sex were analyzed, significant differences were observed only in women. Women affected by right colon cancer also had a statistically significant higher incidence of previous cholecystectomy (relative risk 2.86, p = 0.0096), but no significantly higher incidence of concomitant gallstones. The general increased relative risk in patients with right colon cancer and decreased risk in patients with left colon cancer of concomitant gallstones and prior cholecystectomy was statistically significant. Our data provide evidence for the hypothesis that both gallstones and cholecystectomy increase the general risk of large bowel cancer. Therefore, they are also compatible with the possibility that common risk factors causes the association between gallstones and large bowel cancer.

Aged↗
PubMed1992

[Laparoscopic cholecystectomy. Initial experiences].

Between February 1991 and July 1991, 74 laparoscopic cholecystectomies were performed. The number of all cholecystectomies during this period was 168. Two surgeons performed the operations. Stone in the common bile duct, old age, acute cholecystitis, severe obesity and heart rhythm disorders were regarded as contraindications. The duration of the operation was 45-210 min. (mean 127 min). The intervention was diverted to open cholecystectomy in 2 instances (2.7%). Early postoperative complications were observed in 2 cases (2.7%): biliary discharge and bleeding. Reoperation was necessary in one patient (1.3%) because of bleeding. There was no operative mortality. The mean duration of hospitalization was 5.6 days, and the mean postoperative period was 2.7 days. It is considered that, laporoscopic cholecystectomy can be carried out only by specialists in both bile surgery and laparoscopic techniques, provided that all the personal and technical conditions necessary for traditional cholecystectomies are at hand. Both medically and economically, the laparoscopic cholecystectomy results attain or even exceed those of the traditional open technique.

Adult↗
PubMed2004

Cholesterolosis. Incidence, correlation with serum cholesterol level and the role of laparoscopic cholecystectomy.

OBJECTIVE: To report the incidence of cholesterolosis in the surgically removed gallbladders, its association with serum cholesterol level and to review the role of laparoscopic cholecystectomy in the treatment. METHODS: This retrospective study included all patients who had consecutive cholecystectomies for various gallbladder disorders, performed by 2 consultants during a 5-year period from January 1997 through to December 2002, in the College of Medicine and King Khalid University Hospital, King Saud University, Riyadh, Kingdom of Saudi Arabia. The clinical records of those found to have cholesterolosis on histopathological examination were reviewed, and the data were analyzed for their age, sex, fasting serum cholesterol level and the final outcome of cholecystectomy. RESULTS: The study group was comprised of 549 patients and out of which, 74 (13.4%) had cholesterolosis of the gallbladder. There were 59 (79.9%) female and 15 (20.1%) male patients. Age ranged from 18-64-years with a mean of 35.7-years. Sixty-three (85.1%) cases were reported to have abnormally high fasting serum cholesterol levels (>=5.5 mmol/L), whereas 11 (14.9%) had normal serum cholesterol level. Cholesterolosis with coexistent gallstones was documented in 47 (63.3%) patients while 27 (36.5%) subjects showed acalculous cholesterolosis. Laparoscopic cholecystectomy was performed in 71 (95.9%) individuals, whereas 3 patients ended up with open cholecystectomy (conversion rate of 4.2%). There were no postoperative complications. CONCLUSION: Cholesterolosis of the gallbladder is a distinct pathologic entity and carries a positive correlation with high serum cholesterol level. Laparoscopic cholecystectomy is effective, safe and a feasible treatment modality for cholesterolosis.

Adolescent↗
PubMedDate not supplied

Laparoscopic cholecystectomy: analytical study of 1208 cases.

BACKGROUND/AIMS: To review our experience and to compare it with similar series published in the literature with emphasis on the safety, the rate of conversion, the mortality and the morbidity of the procedure. METHODOLOGY: From January 1994 to February 2003, the files of 1208 cases of laparoscopic cholecystectomy were retrospectively analyzed; the technique of surgery as well as the associated co-morbid conditions, the rate of conversion to open cholecystectomy, and the morbidity and mortality was analyzed and compared to other series. Simple descriptive statistics were used. RESULTS: The average age was 47.2 +/- 15.1 years (4-94), there were 878 (72.7%) females and 330 (27.3%) males. Of this series 20 patients underwent laparoscopic cholecystectomy while pregnant, 576 (48%) of the patients had co-morbid conditions. Conversion to open cholecystectomy was required in 32 (2.6%) cases and 25 (2.1%) patients had complications but no single biliary tract injury was noted. One patient died and his death was not directly related to the procedure. The average hospital stay was 2.8 (0.5-35) days. CONCLUSIONS: With patience and meticulous technique laparoscopic cholecystectomy in the third millennium is safer and quicker than open cholecystectomy. Our results compare favorably with those published to date.

Adolescent↗
PubMed1992

[3606 cholecystectomies under celioscopy. The Register of the French Society of Digestive Surgery].

Early results of laparoscopic cholecystectomy must be evaluated. In this way, the "Société Française de Chirurgie Digestive" started to collect records of laparoscopic cholecystectomies from December 1989. 119 surgeons from 67 departments of surgery have been included in this study. By February 1992, 3,606 procedures were collected. The mean age of these patients was 51 years. Sex ratio was 0.29. 21.5% of patients had a history of acute cholecystitis. An operative cholangiogram was performed in 6.4% of cases. The mean operating time was 80 minutes. An immediate laparotomy was required in 7.1% of cases including 12 common bile duct injuries. Postoperative complications were detected in 4.3% of patients. Among these, 51 patients needed a second operative procedure including 13 common bile duct injuries. Two patients died in the postoperative period (mortality: 0.056%). The mean hospital stay was 4.8 days. History of acute cholecystitis increased significantly the immediate laparotomy required (p less than 0.01) and the incidence of postoperative complications (p less than 0.01). The mortality of laparoscopic cholecystectomy seems to be equivalent to that of open cholecystectomy. On the other hand, the incidence of common bile duct injury seems to be increased. However, the absence of controlled study prevents us from comparing the results with the open cholecystectomy. Furthermore, the incomplete nature of this register prevents us from concluding whether it reflects the real dangers of laparoscopic cholecystectomy. A more rigorous evaluating method should be considered in the future.

Adolescent↗
PubMedDate not supplied

Verres needle decompression of distended gallbladder to facilitate laparoscopic cholecystectomy in acute cholecystitis: a prospective study.

BACKGROUND/AIMS: Grasping a thick and distended gallbladder is one of the most common technical difficulties of laparoscopic cholecystectomy in acute cholecystitis. This prospective study was conducted to investigate the use of the Verres needle decompression method to facilitate laparoscopic cholecystectomy in acute cholecystitis. METHODOLOGY: Between April 1998 and April 2002, patients with acute cholecystitis scheduled to receive laparoscopic cholecystectomy emergently were included. A Verres needle was applied through the subcostal area to decompress the acute inflamed distended gallbladder after establishing pneumoperitoneum. RESULTS: In total 54 patients, 30 male and 24 female with mean age 53.50 years (range 21-80), consented to the operation. Laparoscopic cholecystectomy was performed successfully in 44 patients. The conversion of laparoscopic cholecystectomy to open surgery was needed in 10 patients (conversion rate: 18.5%). The failure to identify the triangle of Calot is the only risk factor associated with conversion. The more severe acute cholecystitis is, the higher the conversion rate is (11.5% in uncomplicated cholecystitis, 31.6% in complicated cholecystitis). No bile duct injury was noted. Postoperative morbidity happened in three cases: two port-site discharge and one subphrenic abscess. No mortality occurred. CONCLUSIONS: Verres needle decompression of the acute inflamed gallbladder did facilitate laparoscopic cholecystectomy in acute cholecystitis with low conversion rate.

Acute Disease↗
PubMedDate not supplied

Relevance of day care laparoscopic cholecystectomy in a developing nation.

Feasibility, safety and success of day care laparoscopic cholecystectomy (DCLC) has been well established in advanced countries. The information on (DCLC) is not available from developing nations. All patients of gallstone disease undergoing laparoscopic cholecystectomy under the care of the two participating surgeons at the post graduate Institute of Medical Education & Research were considered for day care laparoscopic cholecystectomy. The selection criteria were: elective cases only, patients less than 70 years, American Society of Anesthesiologists (ASA) grade I and Grade II, living within 20 Kilometers of the hospital, availability of a responsible adult carer at home, access to a telephone and a means of transportation to hospital if needed. Clinical and operative data were recorded prospectively. All patients were discharged 6 to 8 hours after surgery with the advice to contact the surgical team over phone whenever necessary or on the day after discharge. Out of the total 236 laparoscopic cholecystectomy performed over a period of 26 months, 106 patients (44.9%) underwent laparoscopic cholecystectomy as day care procedure. Five patients (4.8%) were admitted after surgery. Four patients were admitted because of conversion and one patient was admitted because of suspected myocardial infarction. Hundred and one patients (95.2%) were discharged on the same day. There was no major morbidity and patient's acceptance was high. Day care laparoscopic cholecystectomy is feasible, safe, and acceptable to patients.

Adolescent↗
PubMedDate not supplied

Laparoscopic cholecystectomy in the elderly.

OBJECTIVE: To evaluate the outcomes of laparoscopic cholecystectomy in elderly patients at a single institution. METHODS: A retrospective chart review was conducted of all patients > or = 65 years of age who underwent laparoscopic cholecystectomy over a 5-year period (January 1995 to December 1999). Four-trocar site laparoscopic cholecystectomy using the open Hasson technique were performed in all patients. The demographic data (age, sex), associated comorbidities, American Society of Anesthesiologist's (ASA) score, postoperative morbidity, mortality, and length of stay were recorded for each patient. Statistical analysis was done using Fisher's exact test and chi-square analysis. Statistical significance was defined as P < or = 0.05. RESULTS: The patient cohort included 46 patients with a median age of 71 years (range, 65 to 87). Seventeen (37%) patients were < or = 70 years of age, and twenty-nine (63%) patients were > or = 70 years of age. Twenty-two (48%) patients had ASA scores of > or = 3. Patients > or = 70 had significantly higher ASA scores. Eighteen patients > or = 70 years had ASA > or = 3 compared with 4 patients < or = 70 with ASA > or = 3 (P<0.05). Twenty-two patients > or = 70 and 8 patients < or = 70 required urgent surgery P<0.05). Fifteen (33%) patients presented with acute cholecystitis, and 31 (67%) patients presented with a greater number of chronic symptoms. Four (9%) patients had pancreatitis on presentation, and 6 patients underwent preoperative endoscopic retrograde cholangiopancreatography (ERCP). Two of these 6 patients also underwent sphincterotomy. Urgent surgery was performed in 30 (65%) patients. The mean operative time was 103 +/- 37 (SD) minutes. One (2%) conversion to open cholecystectomy was required. The mean postoperative stay was 7 days (range, 1 to 46). Fourteen (30%) patients had only a 1-night postoperative stay. Patients > or = 70 had significantly longer postoperative stays. Nine patients > or = 70 and only 1 patient < or = 70 stayed in the hospital for more than 7 days. Postoperative complications were noted in 6 (13%) patients, most of which were chest infections. Five patients > or = 70 and only 1 patient < or = 70 developed postoperative complications. No mortalities occurred. CONCLUSION: Laparoscopic cholecystectomy is safe and feasible in elderly patients. Patients > or = 70 years seem to have a longer postoperative stay and slightly more postoperative complications. Age alone should not be a contraindication to laparoscopic cholecystectomy in the elderly patient.

Aged↗