Morbimortality of elderly patients submitted to cholecystectomy by laparotomy, minilaparotomy or videolaparoscopy

Background - Cholelithiasis is one of the most frequent diseases regarding the digestive system. It is present in about 20% of the adult population, being age an important predictive factor for complications after cholecystectomy. Aim. -To evaluate the morbitnortality rates concerning elderly patients who undenvent cholecystectomy and who are submitted to conventional practices, minilaparotomy and laparoscopy. Methods - Five hundred and fifty seven patients submitted to cholecystectomy, associated or not to other procedures on the biliary tract, were observed during the period of July 1985 and December 2003. One hundred and fifty two (27,3%) were 60 years or over and 120 (79%) were female. Ninety two were submitted to conventional practices, 46 to laparoscopy and 14 to minilaparototny. Results - Complications were frequent and serious in elder patients and the ones submitted to conventional practices presented greater incidence of urinary infection, surgical wound infection and a longer time of hospitalization. There were three obits, two of them after conventional surgery and the other after videolaparoscopic surgery. All of the patients vi ere over 70 years old. Conclusion - It was possible to conclude that age is an important predictive factor of complications after cholecystectomy as a result of the increase in the incidence of biliary tract disease as well as because of a greater morbidity and mortality in elderly patients resulting from associated diseases.