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2007 | 79 | 2 | 92-97
Article title

Multicenter Analysis of 74 000 Cholecystectomies Age Dependent Morbidity and Transfusion Rate

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EN
Abstracts
EN
The aim of the study multicenter analysis of risc factors during 74 000 cholecystectomies to establish age dependent morbidity and transfusion rate.Material and methods. Between 1th January 1993 and 31th December 1997, 74 049 patients overall in 178 surgical departments with the diagnoses of cholecystolithiasis or cholecystitis were included into a prospective database.Results. The most frequently used method of cholecystectomy was the laparoscopic technique in patients up to 70 years of age. With increasing age, the proportion of laparotomy to laparoscopy procedures inverts; in patients over 70 years of age, open cholecystectomy was the most common method used. In the group of patients older than 90 years, 67.6% of patients were operated by laparotomy and 21.9% laparoscopically (conversion rate 3%).In the age group of 41-50 years, less than 5% of cholecystectomies were performed as emergency cases. This proportion was increased with age continuously up to 46.2% in patients over 90 years of age. After elective cholecystectomy, the postoperative morbidity rate increased continuously from 5.3% to 21.7% in relationship to the patient age. In cases of emergency cholecystectomy, the morbidity rates were higher in all age groups ranging from 12.7% in patients between 31 and 40 years to 34.6% in patients over 90 years of age.Mortality rates also increased continuously from 0.1% to 3.5% after elective cholecystectomy and from 2.9% up to 12.5% after emergency cholecystectomy depending on the age of the patient. The transfusion rate was 0% to 16.6%, increased with age from 0.8 to 5.5% in the cases of elective operations and from 3.8% to 16.6% in the cases of emargancy operations in erderly patients.Conclusions. 1. The number of complication after elective cholecystectomies were low, increase it the case of emergency. 2. In the group of elderly patients laparotomy was done more frequently then laparoscopy. 3. The number of emergency operations increased in elderly patients. 4. The postoperative morbidity, mortality and transfusion rate increase in relationship to the patient age
Publisher
Year
Volume
79
Issue
2
Pages
92-97
Physical description
Dates
published
1 - 2 - 2007
online
24 - 9 - 2007
References
  • Usal H, Sayad P, Hayek N et al.: Major vascular injuries during laparoscopic cholecystectomy. An institutional review of experience with 2589 procedures and literature review. Surg Endosc 1998; 12: 960-62.
  • Wherry DC, Marohn MR, Malanoski MP et al.: An external audit of laparoscopic cholecystectomy in the steady state performed in medical treatment facilities of the Department of Defense. Ann Surg 1996; 224: 145-54.
  • Boeckl O: Planung bei abdominellen Eingriffen. In: Boeckl O, Waclawiczek HW (ed.) Standards in der Chirurgie. München: Zuckschwerdt Verlag; 1994; 122-34.
  • Goodnough LT, Verbrugge D, Vizmeg K et al.: Identifying elective orthopedic surgical patients transfused with amounts of blood in excess of need: the transfusion trigger revisited. Transfusion 1992; 32: 648-53.
  • Nathanson LK, Shimi S, Cuschieri A: Laparoscopic cholecystectomy: the Dundee technique. Br J Surg 1991; 78: 155-59.
  • Schaupp W, Menges HW, Schworm HD: Die ideale Cholezystektomie: eine prospektiv randomisierte Studie. Chirurg 1988; 59: 661-64.
  • Daradkeh S: Laparoscopic cholecystectomy: what are the factors determining difficulty? Hepatogastro-enterology 2001; 48: 76-78.
  • Eubanks TR, Clements RH, Pohl D et al.: An objective scoring system for laparoscopic cholecystectomy. J Am Coll Surg 1999; 189: 566-74.
  • Kologlu M, Tutuncu T, Yuksek YN et al.: Using a risk score for conversion from laparoscopic to open cholecystectomy in resident training. Surgery 2004; 135: 282-87.
  • Takegami K, Kawaguchi Y, Nakayama H et al.: Preoperative grading system for predicting operative conditions in laparoscopic cholecystectomy. Surg Today 2004; 34: 331-36.
  • Behrman SW, Melvin WS, Babb ME et al.: Laparoscopic cholecystectomy in the geriatric population. Am Surg 1996; 62: 386-90.
  • Mannke KH, Raestrup H: Laparoskopische Cholecystektomie. In: Durst M, Rohen W (ed.) Bauchchirurgie. Wiesbaden: Schattauer Verlag; 1996: 530-38.
  • Opitz I, Gantert W, Giger U et al.: Bleeding remains a major complication during laparoscopic surgery: analysis of the SALTS database. Langenbecks Arch Surg 2005; 390: 128-33.
  • Pistorius GA, Hildebrandt U, Schuder G et al.: Standortbestimmung laparoskopische Cholecystektomie. Anasthesiol Intensivmed Notfallmed Schmerzther 1995; 30: 438-41.
  • Golden WE, Cleves MA, Johnston JC: Laparoscopic cholecystectomy in the geriatric population. J Am Geriatr Soc 1996; 44: 1380-83.
  • Gonzalez JJ, Sanz AL, Grana Lopez JL et al.: Gallstone disease in patients over the age of 80. Surgery or long-term medical treatment? Rev Esp Enferm Dig 1997; 89: 196-205.
  • Magnuson TH, Ratner LE, Zenilman ME et al.: Laparoscopic cholecystectomy: applicability in the geriatric population. Am Surg 1997; 63: 91-96.
  • Deziel DJ, Millikan KW, Economou SG et al.: Complications of laparoscopic cholecystectomy: a national survey of 4,292 hospitals and an analysis of 77,604 cases. Am J Surg 1993; 165: 9-14.
  • Escarce JJ, Shea JA, Chen W et al.: Outcomes of open cholecystectomy in the elderly: a longitudinal analysis of 21 000 cases in the prelaparoscopic era. Surgery 1995; 117: 156-64.
  • Sakuramoto S, Sato S, Okuri T et al.: Preoperative evaluation to predict technical difficulties of laparoscopic cholecystectomy on the basis of histological inflammation findings on resected gall-bladder. Am J Surg 2000; 179: 114-21.
  • Maxwell EL, Metz J, Haeusler MN et al.: Use of red blood cell transfusions in surgery. ANZ J Surg 2002; 72: 561-66.
  • Bundesärztekammer. Richtlinien zur Bluttransfusion. Köln: Deutscher Ärzte-Verlag; 1995.
  • Ceccherini-Nelli L, Filipponi F, Mosca F et al.: The risk of contracting an infectious disease from blood transfusion. Transplant Proc 2004; 36: 680-82.
  • Hill GE, Frawley WH, Griffith KE et al.: Allogeneic blood transfusion increases the risk of postoperative bacterial infection: a meta-analysis. J Trauma 2003; 54: 908-14.
  • Amin M, Fergusson D, Wilson K et al.: The societal unit cost of allogenic red blood cells and red blood cell transfusion in Canada. Transfusion 2004; 44: 479-86.
  • Pinkerton PH, Coovadia AS, Seigel C: Audit of the use of packed red blood cells in association with seven common surgical procedures. Transfus Med 1992; 2: 231-34.
Document Type
Publication order reference
YADDA identifier
bwmeta1.element.-psjd-doi-10_2478_v10035-007-0015-9
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