Cholecystectomy under epidural anesthesia in elderly patients with significant comorbid conditions

Mehmet Arif USTA; Serkan TAYAR; Murat Emre REİS; Mehmet ULUŞAHİN; Etem ALHAN

doi:https://doi.org/10.17826/cumj.1000941

Article Details

Cholecystectomy under epidural anesthesia in elderly patients with significant comorbid conditions

Authors:

Mehmet Arif USTA | Serkan TAYAR | Murat Emre REİS | Mehmet ULUŞAHİN | Etem ALHAN

Publisher:

Cukurova University

Main Topics:

Diseases

Journal:

Cukurova Medical Journal 2022 Vol.47 Issue 2, pp.548-554

Document Type:

Article

Publication Date:

6/2022

Document Language:

English

Document ID (Org No.):

2000914264

Frequency:

Quarterly

eISSN:

2602-3040

pISSN:

2602-3032

DOI:

https://doi.org/10.17826/cumj.1000941

Keywords:

Abstract:

 

Purpose: The aim of this study was to evaluate the surgical treatment of gallstone disease with open cholecystectomy under epidural anesthesia in elderly patients with significant comorbid conditions.
Materials and Methods: We retrospectively analyzed 80 consecutive elderly patients over 65 years of age with significant comorbid conditions who underwent open cholecytectomy under epidural anesthesia for the surgical treatment of gallstone disease between January 1, 2009 and December 31, 2019, all performed by one surgeon.
Results: Mean age was found 77 ± 16 years.  Fifty of the patients (62.5%) were females. Forty-seven patients (58.75%) showed an American Society of Anesthesiologist Physical Status (ASA, PS) of 3. The most frequently associated comorbidity involved the cardiovascular system (46 patients, 57.5%). Surgical indications were acute cholecystitis (AC) in 37 patients (46.25%) and chronic cholecystitis in 32 patients (40%). Mean operation time was 55 ± 22 minutes. Hospital stay was mean 12 ± 5 days. Total complication rate was 38.75%, and pulmonary complication was the most frequently encountered (13.75%). 30-day mortality was seen in 5 patients (6.25%). 
Conclusion: In older, high-risk gallstone patients, an open cholecystectomy with epidural anesthesia may be recommended. For this patient population, the mortality and morbidity rates are acceptable.

 

Amaç: Bu çalışmanın amacı, önemli komorbid durumları olan yaşlı hastalarda epidural anestezi altında açık kolesistektomi ile safra taşı hastalığının cerrahi tedavisini değerlendirmektir.
Gereç ve Yöntem: 1 Ocak 2009 ile 31 Aralık 2019 tarihleri arasında safra kesesi taşı cerrahi tedavisi için epidural anestezi altında açık kolesitektomi uygulanan, önemli komorbid durumları olan 65 yaş üstü 80 ardışık yaşlı hastayı geriye dönük olarak inceledik. Hastalar tek bir cerrah tarafından ameliyat edildi.
Bulgular: Ortalama yaş 77 ± 16 yıl olarak bulundu. Hastaların 50'si (% 62.5) kadındı. Kırk yedi hastanın (% 58.75) Amerikan Anestezi Uzmanları Derneği Fiziksel Skoru >3 idi. Eşlik eden en sık komorbiditeler kardiyovasküler sistemle ilgili idi (46 hasta, % 57.5). Cerrahi endikasyonlar 37 hastada (% 46.25) akut kolesistit (AK), 32 hastada (% 40) kronik kolesistit idi. Ortalama operasyon süresi 55 ± 22 dakika idi. Ortalama hastanede kalış süresi 12 ± 5 gündü. Toplam komplikasyon oranı % 38.75 olup, en sık pulmoner komplikasyonlar (% 13.75) ile karşılaşıldı. 30 günlük mortalite 5 hastada (% 6.25) görüldü.
Sonuç: İleri yaşlı, yüksek riskli safra taşı hastalarında epidural anestezi ile açık kolesistektomi önerilebilir. Bu hasta popülasyonu için mortalite ve morbidite oranları kabul edilebilir düzeydedir.

Article Details

Cholecystectomy under epidural anesthesia in elderly patients with significant comorbid conditions

Authors:

Mehmet Arif USTA | Serkan TAYAR | Murat Emre REİS | Mehmet ULUŞAHİN | Etem ALHAN

Publisher:

Cukurova University

Main Topics:

Diseases

Journal:

Cukurova Medical Journal 2022 Vol.47 Issue 2, pp.548-554

Document Type:

Article

Publication Date:

6/2022

Document Language:

English

Document ID (Org No.):

2000914264

Frequency:

Quarterly

eISSN:

2602-3040

pISSN:

2602-3032

DOI:

https://doi.org/10.17826/cumj.1000941

Safra taşı hastalığı

yüksek riskli hastalar

komorbid durumlar

epidural anestezi

açık kolesistektomi

Issues

Article Details

Cholecystectomy under epidural anesthesia in elderly patients with significant comorbid conditions

Authors: Mehmet Arif USTA | Serkan TAYAR | Murat Emre REİS | Mehmet ULUŞAHİN | Etem ALHAN

Publisher: Cukurova University

Main Topics: Diseases

Journal: Cukurova Medical Journal 2022 Vol.47 Issue 2, pp.548-554

Document Type: Article

Publication Date: 6/2022

Document Language: English

Document ID (Org No.): 2000914264

Frequency: Quarterly

eISSN: 2602-3040

pISSN: 2602-3032

DOI: https://doi.org/10.17826/cumj.1000941

Safra taşı hastalığı

yüksek riskli hastalar

komorbid durumlar

epidural anestezi

açık kolesistektomi

Issues

Authors:

Mehmet Arif USTA | Serkan TAYAR | Murat Emre REİS | Mehmet ULUŞAHİN | Etem ALHAN

Publisher:

Cukurova University

Main Topics:

Diseases

Journal:

Cukurova Medical Journal 2022 Vol.47 Issue 2, pp.548-554

Document Type:

Article

Publication Date:

6/2022

Document Language:

English

Document ID (Org No.):

2000914264

Frequency:

Quarterly

eISSN:

2602-3040

pISSN:

2602-3032

DOI:

https://doi.org/10.17826/cumj.1000941