Laparoscopic cholecystectomy in the elderly


Gall bladder
Laparoscopic cholecystectomy

How to Cite

Adhikari, D., Bhattarai, A., Yadav, D. K., Poudel, S., Parajuli, B., Koirala, A., & Yadav, R. P. (2023). Laparoscopic cholecystectomy in the elderly: An experience at a tertiary care hospital in eastern Nepal. Journal of Kathmandu Medical College, 12(1), 45–48. Retrieved from


Background: The prevalence of laparoscopic cholecystectomy in Nepal ranges from 2.44% to 6.45%. The prevalence of gallstones increases with age. Age is considered to be one of the major risk factors in determining the results of morbidity and mortality during laparoscopic cholecystectomy. Laparoscopic cholecystectomy is the gold standard modality for the management of gallstones.

Objectives: The aim of this study was to determine the clinical outcome of laparoscopic cholecystectomy in the elderly.

Methods: This was a descriptive cross-sectional observational study done after ethical clearance. Retrospective data were included of all the patients’ aged ?60 years who underwent laparoscopic cholecystectomy at Nobel Medical College Teaching Hospital, Biratnagar, Morang, Nepal from 2021 July to 2022 June using convenience sampling. Data were entered in Microsoft Excel Sheet and descriptive findings are presented.

Results: A total of 1688 laparoscopic cholecystectomies were performed during the study duration. Consecutively, 250 elderly patients who underwent were included in the study. The mean age of the elderly was 67.88 years. The incidence of the elderly at the institute was 26.7% (452/1688). In the present study, 95 (38%) elderly patients had some kind of comorbidities. Isolated intraoperative complications were seen in 26 (10.4%) patients. Post-operative complications were seen in 53 (21.2%) patients. The need to convert laparoscopic cholecystectomy to open cholecystectomy was observed in 3 (1.2%).

Conclusion: For the elderly, laparoscopic cholecystectomy is a safe and reliable modality. They benefit from this mode of treatment without increasing the risk of surgery.



Gyedu A, Adae-Aboagye K, Badu-Peprah A. Prevalence of cholelithiasis among persons undergoing abdominal ultrasound at the komfoanokye teaching hospital, kumasi, ghana. Afr Health Sci. 2015;15(1):246-52. [Full Text | DOI]

Chaudhary S. Epidemiology of gall stone diseases among patients attending surgical department of a tertiary care hospital in nepal. Janaki Medical College Journal of Medical Sciences. 2020;8(1):50-5. [Full Text | DOI]

Kuy S, Sosa JA, Roman SA, Desai R, Rosenthal RA. Age matters: A study of clinical and economic outcomes following cholecystectomy in elderly Americans. Am J Surg. 2011;201(6):789-96. [PubMed | Full Text | DOI]

Hendrickson M, Naparst TR. Abdominal surgical emergencies in the elderly. Emerg Med Clin North Am. 2003;21(4):937-69. [PubMed | Full Text | DOI]

Bedirli A, Sakrak O, Sözüer EM, Kerek M, Güler I. Factors effecting the complications in the natural history of acute cholecystitis. Hepatogastroenterology. 2001;48(41):1275-8. [PubMed | Full Text]

Jiménez PP, Ruiz-Tovar J, Ramiro C, Molina JM, Morales V, Lobo E. Outcome of laparoscopic cholecystectomy in patients 85 years and older. American Surgeon. 2014;80(11):290-2. [PubMed | Full Text | DOI]

de Mestral C, Rotstein OD, Laupacis A, Hoch JS, Zagorski B, Nathens AB. A population-based analysis of the clinical course of 10,304 patients with acute cholecystitis, discharged without cholecystectomy. J Trauma Acute Care Surg. 2013;74(1):26-30. [PubMed | Full Text | DOI]

Mayol J, Martinez-Sarmiento J, Tamayo FJ,Fernández-RepresaJA. Complications of laparoscopic cholecystectomy in the ageing patient. Age Ageing. 1997;26(2):77-81. [Full Text | DOI]

Malik AM, Talpur KAH, Memon A, Pathan R,Memon JM. Laparoscopic cholecystectomy in the elderly patients. An experience at liaquat university hospital jamshoro. J Ayub Med Coll Abbottabad. 2007;19(4):45-8. [PubMed | Full Text]

Tambyraja AL, Kumar S, Nixon SJ. Outcome of laparoscopic cholecystectomy in patients 80 years and older. World J Surg. 2004;28(8):745-8. [Full Text | DOI]

Kirshtein B, Bayme M, Bolotin A, Mizrahi S, Lantsberg L. Laparoscopic cholecystectomy for acute cholecystitis in the elderly: Is it safe? Surg Laparosc Endosc Percutan Tech. 2008;18(4):334-9. [Full Text | DOI]

Bhandari TR, Shahi S, Bhandari R, Poudel R. Laparoscopic cholecystectomy in the elderly: An experience at a tertiary care hospital in western nepal. Surg Res Pract. 2017;2017:1-5. [Full Text | DOI]

Yetkin G, Uludag M, Oba S, Citgez B, Paksoy I. Laparoscopic Cholecystectomy in Elderly Patients. JSLS. 2009;13(4):587-91. [PubMed | Full Text | DOI]

O’leary E, Hubbard K, Tormey W, Cunningham AJ. Laparoscopic cholecystectomy: Haemodynamic and neuroendocrine responses after pneumoperitoneum and changes in position. Br J Anaesth. 1996;76:640-4. [PubMed | Full Text | DOI]

Genc V, Sulaimanov M, Cipe G, Basceken SI, Erverdi N, Gurel M, et al. What necessitates the conversion to open cholecystectomy? A retrospective analysis of 5164 consecutive laparoscopic operations. Clinics. 2011;66(3):417-20. [PubMed | Full Text | DOI]

Pessaux P, Tuech JJ, Duplessis R, Seicean R, Arnaud JP. Laparoscopic cholecystectomy after age 75. Chirurgie. 1999;124(4):419-22. [PubMed | Full Text | DOI]

Struthers AD, Cuschieri A. Cardiovascular consequences of laparoscopic surgery. Lancet. 1998;352(9127):568-70. [Full Text | DOI]

Gautam B, Shrestha BR. Cardiac arrest during laparoscopic cholecystectomy under general anaesthesia: a study into four cases. Kathmandu Univ. Med. J. 2010;7(3):280-8. [Full Text | DOI]

Gutt CN, Oniu T, MehrabiA,et al.irculatory and respiratory complications of carbon dioxide insufflation. Dig Surg. 2004;21(2):95-105. [PubMed | Full Text | DOI]

Atkinson TM, Giraud GD, Togioka BM, Jones DB, Cigarroa JE. Cardiovascular and ventilatory consequences of laparoscopic surgery. Circulation. 2017;135:700-10. [PubMed | Full Text | DOI]

Qureshi FA. Anaesthesia related complications of laparoscopic cholecystectomy. J Coll Physicians Surg Pak. 2003 Jul;13(7):369-71. [PubMed | Full Text]

Simopoulos C, Botaitis S, Polychronidis A, Tripsianis G,Karayiannakis AJ. Risk factors for conversion of laparoscopic cholecystectomy to open cholecystectomy. Surgical Endoscopy. 2005;19(7):905-9. [PubMed | Full Text | DOI]