Impact of preoperative management in patients older than 80 years requiring cholecystectomy

BACKGROUNDS/AIMS: Elderly patients aged >80 yr have high morbidity and mortality rates after biliary surgery, especially in emergency operations. We conducted this study to determine the effect of preoperative management on the outcome of elderly patients undergoing cholecystectomy. METHODS: The medical records of 452 elderly (≥80 yr old) patients who underwent cholecystectomy from January 1997 to December 2015 were reviewed retrospectively. We divided the patients into 2 groups: intervention (preoperative biliary drainage) and non-intervention groups. We evaluated the effects of preoperative management on the American Society of Anesthesiology (ASA) score and perioperative outcomes. RESULTS: Among the preoperative biliary drainage intervention group (n=286), 48 patients (51.7%) were diagnosed as having gallbladder stone combined with common bile duct stone. On admission, the proportion of patients with ASA score ≥3 and WBC counts were significantly higher in the intervention group than in the non-intervention group (p<0.05). The preoperative hospital stay was longer in the intervention group; however, operation-related factors such as operation type, time, conversion rate, complications, and mortality showed no difference between groups. CONCLUSIONS: With proper preoperative evaluations and preoperative biliary drainage, cholecystectomy can be a safe treatment option for elderly patients with cholelithiasis.