Comparative Study of Laparoscopic Cholecystectomy Versus Open Cholecystectomy in Elderly Patients: An Observational Comparative Study

Abstract

Background: Surgery for cholelithiasis is more common in elderly patients as the incidence of gallstones increases with age. Age is one of the critical factors affecting the mortality and morbidity rates after open cholecystectomy (OC). The aim of this report was to evaluate and comparing the outcome of laparoscopic cholecystectomy (LC) in elderly patients (≥ 65 years old) with that of OC.
Methods: A prospective observational comparative study was conducted in the Department of General Surgery at R.G. Kar Medical College and Hospital, India, from January 2012 to June 2013. 50 patients were involved. Group 1 had patients planned for conventional LC, i.e., LC group and Group 2 with OC, i.e., OC group. Patients included were the cases who aged 65 years and above, with symptomatic gallstone disease, with asymptomatic gallstone with associated illnesses or with anticipated complications. Various variables were compared intraoperatively and postoperatively.
Results: Significant differences were seen in LC group with more duration of surgery than OC group. The pain score was significantly low in LC group after 6 and 24 hours. The duration of hospital stay was also significantly less in LC group. Pulmonary function tests were done on 1^st and 6^th post-operative days showed a significant difference of peak expiratory flow rate, forced expiratory volume₁, and forced vital capacity between LC and OC on 1^st post-operative day.
Conclusions: LC should be advised for elderly patients as an elective procedure safely as post-operative morbidity is much less in LC compared to the OC.