TIMING OF LAPAROSCOPIC CHOLECYSTECTOMY IN ELDERLY PATIENTS WITH MILD ACUTE BILIARY PANCREATITIS

Soytaş, Yiğit; ilhan, Mehmet; ERTEKİN, Cemalettin; GÜLOĞLU, Recep; bademler, süleyman; GÖK, Ali Fuat Kaan

TIMING OF LAPAROSCOPIC CHOLECYSTECTOMY IN ELDERLY PATIENTS WITH MILD ACUTE BILIARY PANCREATITIS

Mehmet İLHAN, (İstanbul Üniversitesi, İstanbul Tıp Fakültesi, Genel Cerrahi Anabilim Dalı, İstanbul, Türkiye)

Yiğit SOYTAŞ, (İstanbul Üniversitesi, İstanbul Tıp Fakültesi, Genel Cerrahi Anabilim Dalı, İstanbul, Türkiye)

Ali Fuat Kaan GÖK, (İstanbul Üniversitesi, İstanbul Tıp Fakültesi, Genel Cerrahi Anabilim Dalı, İstanbul, Türkiye)

Süleyman BADEMLER, (İstanbul Üniversitesi, İstanbul Tıp Fakültesi, Genel Cerrahi Anabilim Dalı, İstanbul, Türkiye)

Recep GÜLOĞLU, (İstanbul Üniversitesi, İstanbul Tıp Fakültesi, Genel Cerrahi Anabilim Dalı, İstanbul, Türkiye)

Cemalettin ERTEKİN (İstanbul Üniversitesi, İstanbul Tıp Fakültesi, Genel Cerrahi Anabilim Dalı, İstanbul, Türkiye)

Türk Geriatri Dergisi

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Yıl: 2016 Cilt: 19 Sayı: 3 Sayfa Aralığı: 162 - 168 Metin Dili: Türkçe İndeks Tarihi: 29-07-2022

TIMING OF LAPAROSCOPIC CHOLECYSTECTOMY IN ELDERLY PATIENTS WITH MILD ACUTE BILIARY PANCREATITIS

Öz:

Giriş: Ortalama insan ömrü arttıkça yaşla ilişkili hastalıkların sıklığı artmaktadır. Safra taşına bağlı pankreatit, yaşla ilişkili hastalıklardan biridir ve yaşlanma ile birlikte sıklığı artmaktadır. Bu çalışma, 65 yaşın üstünde biliyer pankreatit tanısıyla yatan ve aynı yatışta laparoskopik kolesistektomi (LK) yapılan hastaların tedavi yöntemlerini ve sonuçlarını değerlendirmeyi amaçlamaktadır. Gereç ve Yöntem: Ocak 2010 - Aralık 2015 tarihleri arasında İstanbul Tıp Fakültesi, Genel Cerrahi Anabilim Dalı'da, biliyer pankreatit tanısıyla erken laparaskopik kolesistektomi yapılan 65 yaş üstü hastalar retrospektif olarak değerlendirildi. Hastalar Grup A (65-75 yaş) ve Grup B (> 75 yaş) olarak ayrıldı. Hastalar, ek hastalıkları, önceden geçirilmiş karın ameliyatı, ameliyat süresi, ameliyat sonrası mortalite/morbitide oranı, hastanede yatış süresi ve Amerika Anesteziyoloji Derneği'nin (ASA) skoruna göre değerlendirildi. Bulgular: Toplam192 akut biliyer panreatit geçiren yaşlı hasta değerlendirildi. Bu hastaların 79'una hastaneye ilk yatışları sırasında akut biliyer pankretit tanısıyla erken LK yapıldı. İki grup arasında ameliyat ve hastanede kalış süresi açısında anlamlı fark saptanmadı. Ameliyat sonrası 8 saat içinde oral gıda alımına başlandı. Grup A ve Grup B arasında mortalite ve morbitite bakımından fark bulunmadı. Sonuç: Yaşlılık ve eşlik eden hastalıklar cerrahi sonuçların esas belirleyicileridir. Erken dönemde LK, hafif pankreatit geçiren yaşlı hastalara taburculuktan önce kabul edilebilir düzeyde mortalite ve morbiditeyle önerilebilir Bu hastalara güvenli ve etkili bir şekilde LK yapılabilir. Kolesistektomi, rekürren pankreatiti önlemede kesin tedavi olabilir.

Anahtar Kelime:

Konular: Cerrahi

HAFİF AKUT BİLİYER PANKREATİT GEÇİREN YAŞLI HASTALARDA LAPAROSKOPİK KOLESİSTEKTOMİ NE ZAMAN YAPILMALI?

Öz:

Introduction: Age-related diseases have increased with the increase in average lifeexpectancy. Biliary pancreatitis is one such disease, and its incidence increases with age. Thisstudy aimed to evaluate treatment outcomes for patients aged >65 years who were hospitalizedfor biliary pancreatitis and underwent cholecystectomy during initial hospitalization.Materials and Method: A retrospective study was designed for patients aged >65 yearswho underwent early cholecystectomy for acute biliary pancreatitis at Istanbul Faculty ofMedicine, Department of General Surgery, between January 2010 and December 2015. Patientswere divided into group A (aged 65-74 years) and group B (aged ?75 years). Patients' demographics, comorbidities, American Society of Anesthesiology (ASA) scores, history of previousabdominal operations, operation duration, postoperative morbidity and mortality, and length ofhospital stay were analyzed. Results: In total, 192 geriatric patients with acute biliary pancreatitis were analyzed.Seventy-nine (45 women, 34 men) of them underwent early LC for acute biliary pancreatitis during initial hospitalization. There was no significant difference in operation duration and length ofhospital stay between the two groups. Postoperative oral intake started within 8 h. No significant difference was found in mortality and morbidity rates between the two groups.Conclusion: Old age and accompanying comorbidities are fundamental predictors of surgical outcomes. Early LC should be suggested in elderly patients with the regression of mild pancreatitis before hospital discharge, with acceptable morbidity and mortality. It is feasible and safefor older patients to undergo LC. Cholecystectomy could be the definitive treatment for gallstonedisease to prevent recurrent pancreatitis.

Anahtar Kelime:

Konular: Cerrahi

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık

Edward LB III. A clinically based classification system for acute pancreatitis. Summary of the International Symposium on Acute Pancreatitis, Atlanta, Ga, September 11 through 13, 1992. Arch Surg 1993 May;128 (5):586-90. (PMID:8489394).
Singh VK, Bollen TL, Wu BU, et al. An assessment of the severity of interstitial pancreatitis. Clin Gastroenterol Hepatol 2011 Dec;9(12):1098-103. doi: 10.1016/j.cgh.2011.08.026. Epub 2011 Sep 3. (PMID:21893128).
Van Santvoort HC, Bakker OJ, Bollen TL, et al. A conservative and minimally invasive approach to necrotizing pancreatitis improves outcome. Gastroenterology 2011 Oct;141(4):1254- 63. (PMID:21741922).
Stinton LM, Shaffer EA. Epidemiology of gallbladder disease: cholelithiasis and cancer. Gut Liver 2012 Apr;6(2):172-87.
Lyon C, Clark C. Diagnosis of acute abdominal pain in older patients. Am Fam Physician 2006 Nov 1;74(9):1537-44. (PMID:17111893).
Agrusa A, Romano G, Frazzetta G, et al. Role and out comes of laparoscopic cholecystectomy in the elderly. Int J Surg 2014;12 Suppl 2:S37-9. (PMID:25159549).
Kuy S, Sosa JA, Roman SA, Desai R, Rosenthal RA. Rosenthal Age matters: a study of clinical and economic outcomes following cholecystectomy in elderly Americans Am J Surg 2011 Jun;201(6):789-96. (PMID:21741511).
Festi D, Dormi A, Capodicasa S, et al. Incidence of gallstone disease in Italy: results from a multicenter population-based Italian study (the MICOL project) World J Gastroenterol 2008 Sep 14;14(34):5282-9. (PMID:18785280).
Bouwense SA, Besselink MG, van Brunschot S, et al. Pancreatitis of biliary origin, optimal timing of cholecystectomy (PONCHO trial): study protocol for a randomized controlled trial. Trials 2012 Nov 26;13:225. (PMID:23181667).
Nealon WH, Bawduniak J, Walser EM. Appropriate timing of cholecystectomy in patients who present with moderate to severe gallstone associated acute pancreatitis with peripancreatic fluid collections. Ann Surg 2004 Jun;239(6):741-9. (PMID:15166953).
Overby DW, Apelgren KN, Richardson W, Fanelli R; Society of American Gastrointestinal and Endoscopic Surgeons. SAGES guidelines for the clinical application of laparoscopic biliary tract surgery Surg Endosc 2010 Oct;24(10):2368-86. (PMID:20706739).
Agresta F, Ansaloni L, Baiocchi GL, et al. Laparoscopic approach to acute abdomen from the Consensus Development Conference of the Società Italiana di Chirurgia Endoscopica e nuove tecnologie (SICE), Associazione Chirurghi Ospedalieri Italiani (ACOI), Società Italiana di Chirurgia (SIC), Società Italiana di Chirurgia d'Urgenza e del Trauma (SICUT), Società Italiana di Chirurgia nell'Ospedalità Privata (SICOP), and the European Association for Endoscopic Surgery (EAES). Surg Endosc 2012 Aug;26(8):2134-64. (PMID:22736283).
Forsmark CE, Baillie J. AGA Institute technical review on acute pancreatitis. Gastroenterology 2007 May;132(5):2022-44. (PMID:17484894).
Lupinacci RM, Nadal LR, Rego RE, Vege SS. Surgical management of gallbladder disease in the very elderly: are we operating them at the right time? Eur J Gastroenterol Hepatol 2013 Mar;25(3):380-4. (PMID:23169310).
Tenner S, Baillie J, DeWitt J, et al. American College of Gastroenterology guideline: management of acute pancreatitis. Am J Gas- troenterol 2013 Sep;108(9):1400-15;1416. (PMID:2389695).
Marcari RS, Lupinacci RM, Nadal LR, Rego RE, Coelho AM, Farah JFM. Outcomes of laparoscopic cholecystectomy in octogenarians. JSLS 2012 Apr-Jun;16(2):271-5. (PMID:23477177).
Visnjevac O, Lee J, Pourafkari L, Dosluoglu HH, Nader ND. Functional capacity as a significant independent predictor of postoperative mortality for octogenarian ASA III patients. J Gerontol A Biol Sci Med Sci 2014 Oct;69(10):1229-35. (PMID:24789693).
Petrov MS, van Santvoort HC, Besselink MG, et al. Early endoscopic retrograde cholangiopancreatography versus conserva- tive management in acute biliary pancreatitis without cholangitis: a meta-analysis of randomized trials. Ann Surg 2008 Feb;247(2):250-7. (PMID:18216529).
Working Party of the British Society of Gastroenterology; Association of Surgeons of Great Britain and Ireland; Pancreatic Society of Great Britain and Ireland; Association of Upper GI Surgeons of Great Britain and Ireland. UK guidelines for the management of acute pancreatitis. Gut 2005 May;54 Suppl 3:iii1-9. (PMID:15831893).
Banks PA, Freeman ML. Practice guidelines in acute pancreatitis. Am J Gastroenterol 2006 Oct;101(10):2379-400. (PMID:17032204).
Shikata S, Noguchi Y, Fukui T. Early versus delayed cholecystectomy for acute cholecystitis: a meta-analysis of randomized controlled trials. Surg Today 2005;35(7):553-60.
Greenberg JA, Hsu J, Bawazeer M, et al. Clinical practice guideline: management of acute pancreatitis. Can J Surg 2016 Apr;59(2):128-40. (PMID:27007094).
Antoniou SA, Antoniou GA, Koch OO, Pointner R, Grande- rath FA. Meta-analysis of laparoscopic vs open cholecystectomy in elderly patients. World J Gastroenterol 2014 Dec 14;20(46):17626-34. (PMID:25516678).
Rao A, Polanco A, Qiu S, et al. Safety of outpatient laparoscopic cholecystectomy in the elderly: analysis of 15248 patients using the NSQIP database J Am Coll Surg 2013 Dec;217(6):1038-43. Epub 2013 Sep 14. (PMID:24045141).

APA	ilhan M, Soytaş Y, GÖK A, bademler s, GÜLOĞLU R, ERTEKİN C (2016). TIMING OF LAPAROSCOPIC CHOLECYSTECTOMY IN ELDERLY PATIENTS WITH MILD ACUTE BILIARY PANCREATITIS. , 162 - 168.
Chicago	ilhan Mehmet,Soytaş Yiğit,GÖK Ali Fuat Kaan,bademler süleyman,GÜLOĞLU Recep,ERTEKİN Cemalettin TIMING OF LAPAROSCOPIC CHOLECYSTECTOMY IN ELDERLY PATIENTS WITH MILD ACUTE BILIARY PANCREATITIS. (2016): 162 - 168.
MLA	ilhan Mehmet,Soytaş Yiğit,GÖK Ali Fuat Kaan,bademler süleyman,GÜLOĞLU Recep,ERTEKİN Cemalettin TIMING OF LAPAROSCOPIC CHOLECYSTECTOMY IN ELDERLY PATIENTS WITH MILD ACUTE BILIARY PANCREATITIS. , 2016, ss.162 - 168.
AMA	ilhan M,Soytaş Y,GÖK A,bademler s,GÜLOĞLU R,ERTEKİN C TIMING OF LAPAROSCOPIC CHOLECYSTECTOMY IN ELDERLY PATIENTS WITH MILD ACUTE BILIARY PANCREATITIS. . 2016; 162 - 168.
Vancouver	ilhan M,Soytaş Y,GÖK A,bademler s,GÜLOĞLU R,ERTEKİN C TIMING OF LAPAROSCOPIC CHOLECYSTECTOMY IN ELDERLY PATIENTS WITH MILD ACUTE BILIARY PANCREATITIS. . 2016; 162 - 168.
IEEE	ilhan M,Soytaş Y,GÖK A,bademler s,GÜLOĞLU R,ERTEKİN C "TIMING OF LAPAROSCOPIC CHOLECYSTECTOMY IN ELDERLY PATIENTS WITH MILD ACUTE BILIARY PANCREATITIS." , ss.162 - 168, 2016.
ISNAD	ilhan, Mehmet vd. "TIMING OF LAPAROSCOPIC CHOLECYSTECTOMY IN ELDERLY PATIENTS WITH MILD ACUTE BILIARY PANCREATITIS". (2016), 162-168.

APA	ilhan M, Soytaş Y, GÖK A, bademler s, GÜLOĞLU R, ERTEKİN C (2016). TIMING OF LAPAROSCOPIC CHOLECYSTECTOMY IN ELDERLY PATIENTS WITH MILD ACUTE BILIARY PANCREATITIS. Türk Geriatri Dergisi, 19(3), 162 - 168.
Chicago	ilhan Mehmet,Soytaş Yiğit,GÖK Ali Fuat Kaan,bademler süleyman,GÜLOĞLU Recep,ERTEKİN Cemalettin TIMING OF LAPAROSCOPIC CHOLECYSTECTOMY IN ELDERLY PATIENTS WITH MILD ACUTE BILIARY PANCREATITIS. Türk Geriatri Dergisi 19, no.3 (2016): 162 - 168.
MLA	ilhan Mehmet,Soytaş Yiğit,GÖK Ali Fuat Kaan,bademler süleyman,GÜLOĞLU Recep,ERTEKİN Cemalettin TIMING OF LAPAROSCOPIC CHOLECYSTECTOMY IN ELDERLY PATIENTS WITH MILD ACUTE BILIARY PANCREATITIS. Türk Geriatri Dergisi, vol.19, no.3, 2016, ss.162 - 168.
AMA	ilhan M,Soytaş Y,GÖK A,bademler s,GÜLOĞLU R,ERTEKİN C TIMING OF LAPAROSCOPIC CHOLECYSTECTOMY IN ELDERLY PATIENTS WITH MILD ACUTE BILIARY PANCREATITIS. Türk Geriatri Dergisi. 2016; 19(3): 162 - 168.
Vancouver	ilhan M,Soytaş Y,GÖK A,bademler s,GÜLOĞLU R,ERTEKİN C TIMING OF LAPAROSCOPIC CHOLECYSTECTOMY IN ELDERLY PATIENTS WITH MILD ACUTE BILIARY PANCREATITIS. Türk Geriatri Dergisi. 2016; 19(3): 162 - 168.
IEEE	ilhan M,Soytaş Y,GÖK A,bademler s,GÜLOĞLU R,ERTEKİN C "TIMING OF LAPAROSCOPIC CHOLECYSTECTOMY IN ELDERLY PATIENTS WITH MILD ACUTE BILIARY PANCREATITIS." Türk Geriatri Dergisi, 19, ss.162 - 168, 2016.
ISNAD	ilhan, Mehmet vd. "TIMING OF LAPAROSCOPIC CHOLECYSTECTOMY IN ELDERLY PATIENTS WITH MILD ACUTE BILIARY PANCREATITIS". Türk Geriatri Dergisi 19/3 (2016), 162-168.