A safety analysis of day-surgery laparoscopic cholecystectomy for elderly patients aged above 65 years with biliary tract diseases

Objective To investigate the safety of day-surgery laparoscopic cholecystectomy (LC/DS) in elderly patients.Methods The clinical data were collected from 4764 patients who underwent LC/DS in PLA General Hospital from November 2009 to July 2015, and a retrospective analysis was performed for the general data, time of operation, intraoperative blood loss, length of postoperative hospital stay, satisfaction rate, reason for delayed discharge, rate of delayed discharge caused by psychological factors, rate of delayed discharge caused by abdominal drainage tube placement, incidence of complications, rate of conversion to laparotomy, readmission rate with 30 days after discharge, and mortality rate of elderly patients (≥65 years) .The clinical data of elderly patients were compared with those of non-elderly patients.The Mann-Whitney U test was used for comparison of non-normally distributed continuous data between groups, and the chi-square test was used for comparison of categorical data between groups.Results A total of 710 elderly patients and 4054 non-elderly patients underwent LC/DS, and no patients died.There were significant differences between these two groups in the time of operation [57.5 (41.8-74.3) min vs 54.0 (40.0-70.0) min, Z=-2.715, P=0.007], intraoperative blood loss [10.0 (5.0-20.0) ml vs 5.0 (0-10.0) ml, Z=-8.604, P<0.001], length of postoperative hospital stay [1.0 (1.0-1.0) d vs 1.0 (1.0-1.0) d, Z=-3.778, P<0.001], overall rate of delayed discharge (20.3% vs 14.8%, χ2=13.637, P<0.001) , rate of delayed discharge caused by psychosocial factors (8.6% vs 6.5%, χ2=4.220, P=0.040) , and rate of delayed discharge caused by abdominal drainage tube placement (4.4% vs 2.0%, χ2=13.909, P<0.001) .There were no significant differences between the two groups in the incidence of complications (6.5% vs 5.9%, χ2=0.334, P=0.563) , rate of conversion to laparotomy (0.8% vs 0.4%, χ2=2.119, P=0.145) , and readmission rate within 30 days after discharge (0.7% vs 0.5%, χ2=0.190, P=0.663) .Conclusion Elderly patients undergoing LC/DS have comparable risks of complications, conversion to laparotomy, and readmission to non-elderly patients, which suggests that LC/DS is safe and feasible.