Type of publication:
Kew T.; Lin A.; Ekeozar C.; Bundred J.; Evans R.; Griffiths E.; Kamarajah S.; *Karri S.; Singh P.
British Journal of Surgery; Jun 2020; vol. 107 ; p. 5-6
Aim: The need to perform elective and emergency cholecystectomy in an ever ageing population increases yet these risks are poorly quantified. The study aims to review the current evidence to quantify further the postoperative risk of cholecystectomy in the elderly population.
Method(s): A systematic literature search of PubMed, EMBASE and the Cochrane Library databases were conducted and a meta-analysis was performed in accordance with the recommendations of the Cochrane Library and PRISMA guidelines.
Result(s): This review identified 99 studies incorporating 333,041 patients. Increasing age was significantly associated with increased rates of overall complications (OR 2.33, CI95%: 2.00-2.71, p<0.001), major complication (OR 2.32, CI95%: 1.52-3.54, p<0.001), risk of conversion to open cholecystectomy (OR 2.32, CI95%: 1.95-2.76, p<0.001), risk of bile leaks (OR 2.05, CI95%: 1.18-3.55, p<0.001), risk of postoperative mortality (OR 5.99, CI95%: 3.77-9.52, p<0.001) and was significantly associated with increased length of stay (MD 2.12 days, CI95%: 1.01-3.24, p<0.001).
Conclusion(s): Post-operative outcomes such as overall and major complications are significantly higher in all age cut-offs. There is six-fold increase in perioperative mortality which increases by nine-fold in patients >80 years old. This study confirms preconceived suspicions of risk in elderly patients undergoing cholecystectomy and will aid treatment planning and informed consent.
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