Revista do Colégio Brasileiro de Cirurgiões
Print version ISSN 0100-6991
BROMBERG, Sanson Henrique et al. Surgical management of biliary tract in the elderly experience in an teaching hospital. Rev. Col. Bras. Cir. [online]. 1998, vol.25, n.3, pp. 161-166. ISSN 0100-6991. http://dx.doi.org/10.1590/S0100-69911998000300003.
Due to high incidence of postoperative complications in elderly people there is some degree of reluctance in the surgical management of the biliar lithiasis in these patients. The main purpose of this study was to verify the real extension of these problem in the Department of Gastroenterologic Surgery of the HSPE-FMO. Over a 6-year period (1990-1995) 185 elderly patients with biliary lithiasis and mean age of 73.0 ± 6,2 years were evaluated. The patients were divided into two groups according to the age: I-118 (63.8%) patients with 60-74 and II- 67 (36.2%) patients with 75-90 years. The number of mate patients was significantly higher at the group II. Symptoms were similar into two groups of patients. The most part of patients was submitted to elective procedures - (163) 88.1% while (22) 1.9% underwent emergency surgery (acute cholecystitis). The number of emergency cases was more than twice in the group II (19.4% versus 7.6%). Cholecystectomy was performed in all patients. Operative cholangiography was performed in 157 (84,8%) patients. Complementary surgery was necessary for 38 (21.6%)patients (choledocholithiasis in 15.1% and papillar stricture in 2.7%) and was higher in the group II. Choledocholithotomy as a component of the primary biliary operation was performed in 28 (15.1%) patients, biliar enteric anastomosis in seven (3.8%) and papillotomy in five (2.7%) patients. Complications occurred in 37 (20%) patients and were similar in both groups. There was no mortality. Retained stones of the common duct was found in 15 (8.1%) patients. Endoscopic sphincterotomy was performed upon all patients, with success. The results of the present study support the use of elective cholecystectomy with low morbidity and without mortality in geriatric patients.
Keywords : Cholelithiasis; Cholecystectomy; Elderly; Surgical treatment.