[Surgery of the biliary tract in geriatric patients (author's transl)]. 1977

E Schima

During 5 years 1311 operations for benign diseases of the biliary tract were performed. 281 patients were more than 70 years old, on the average 76,1 years. According to experience and the results the following is emphasized: 1. Complications of gallstones are relatively more frequent in old patients. 2. Cholecystectomy for chronic gall bladder disease should be performed even in old age. Our postoperative mortality rate was 2,5%, increasing to 15,1% when operation was done in a stage of complications. 3. Acute inflammatory cholecystitis should be treated by urgent operation, especially in old age. 4. Cholecystectomy is the method of choice for acute cholecystitis. Cholecystostomy is used only in few exceptional cases. 5. Cholangiometry and cholangiography are always executed, if the cystic duct can be cannulated, even in cases of acute inflammation. 6. If there are stones in the common duct or a stenosis of Oddi's sphineter is found, an acute inflammatory or perforated cholecystitis is no impediment for a one stage repair. 7. Cholangioscopy is the unsurpassable method for exploring the common duct, when it was opened or sphincterotomy was done. 8. Principally indications for transduodenal sphincterotomy are the same for all age groups. The postoperative mortality rate is not higher than after other operations involving the common duct. 9. In old age choledochoduodenostomy is sometimes a good alternative to sphicterotomy. 10. In cases of recurrent operation due to overlooked stones in the common duct or sclerosis of Oddi's sphincter the mortality rate is not higher than after primary interventions for such affections.

UI MeSH Term Description Entries
D008297 Male Males
D011183 Postoperative Complications Pathologic processes that affect patients after a surgical procedure. They may or may not be related to the disease for which the surgery was done, and they may or may not be direct results of the surgery. Complication, Postoperative,Complications, Postoperative,Postoperative Complication
D012008 Recurrence The return of a sign, symptom, or disease after a remission. Recrudescence,Relapse,Recrudescences,Recurrences,Relapses
D002763 Cholecystectomy Surgical removal of the GALLBLADDER. Cholecystectomies
D002764 Cholecystitis Inflammation of the GALLBLADDER; generally caused by impairment of BILE flow, GALLSTONES in the BILIARY TRACT, infections, or other diseases. Empyema, Gallbladder,Gallbladder Inflammation,Empyema, Gall Bladder,Gall Bladder Empyema,Gallbladder Empyema,Inflammation, Gallbladder
D002769 Cholelithiasis Presence or formation of GALLSTONES in the BILIARY TRACT, usually in the gallbladder (CHOLECYSTOLITHIASIS) or the common bile duct (CHOLEDOCHOLITHIASIS). Gallstone Disease,Cholelithiases,Gallstone Diseases
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000208 Acute Disease Disease having a short and relatively severe course. Acute Diseases,Disease, Acute,Diseases, Acute
D000368 Aged A person 65 years of age or older. For a person older than 79 years, AGED, 80 AND OVER is available. Elderly

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