Which octogenarian patients are at higher risk after cholecystectomy for symptomatic gallstone disease? A single center cohort study
作者机构：Department of General and Oncologic SurgeryMorgagni-Pierantoni HospitalAUSL RomagnaForlì47121Italy Department of Medical and Surgical SciencesUniversity of BolognaBologna 40126Italy
出 版 物：《World Journal of Clinical Cases》 (世界临床病例杂志)
年 卷 期：2022年第10卷第24期
页 面：8556-8567页
核心收录：
学科分类：1002[医学-临床医学] 100210[医学-外科学(含：普外、骨外、泌尿外、胸心外、神外、整形、烧伤、野战外)] 10[医学]
主 题：Cholecystitis Gallstones Choledocholithotomy Elderly Post-operative complications
摘 要：BACKGROUND Incidence of gallstones in those aged≥80 years is as high as 38%-53%.The decision-making process to select those oldest old patients who could benefit from cholecystectomy is *** To assess the risk of morbidity of the“oldest-oldpatients treated with cholecystectomy in order to provide useful data that could help surgeons in the decision-making process leading to surgery in this *** A retrospective study was conducted between 2010 and *** variables were collected and compared between patients who had postoperative complications.A model was created and tested to predict severe postoperative *** The 269 patients were included in the study(193 complicated).The 9.7%of complications were grade 3 or 4 according to the Clavien-Dindo *** levels were lower in patients who did not have any postoperative *** Society of Anesthesiologists scale 4 patients,performing a choledocholithotomy and bilirubin levels were associated with Clavien-Dindo2 complications(P0.001).The decision curve analysis showed that the proposed model had a higher net benefit than the treating all/none options between threshold probabilities of 11%and 32%of developing a severe *** Patients with American Society of Anesthesiologists scale 4,higher level of bilirubin and need of choledocholithotomy are at the highest risk of a severely complicated postoperative *** endoscopic or percutaneous treatments should be considered in this subgroup of octogenarians.
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