Laparoscopic surgery in the elderly

Patients over the age of 65, undergoing either laparoscopic cholecystectomy or laparoscopic groin hernia repair in two centres, were retrospectively reviewed. 114 patients (median age 73) case-notes were reviewed. 94 patients had undergone laparoscopic cholecystectomy and 20 laparoscopic hernia repair. 81% were American society of Anaesthesiologists (ASA) Grade I or II, with 17% Grade III and 2% Grade IV. 8% of the laparoscopic cholecystectomy patients had unsuspected common bile duct stones detected on cholangiography. There was a 5% conversion to open procedure in the cholecystectomy group and 0% in the hernia group. Median hospital stay was 2 days. Mortality was 0% in both groups. Major post-operative morbidity occurred in 4% of the laparoscopic cholecystectomy patients, delaying their discharge. We conclude that laparoscopic surgery is a safe procedure in the elderly patient when accompanied by good patient selection and anaesthetic care.