PDF(Pubmed)
Abstract：
BACKGROUND: The laparoscopic cholecystectomy is the treatment of choice for patients with benign biliary disease. It is necessary to evaluate survival after laparoscopic cholecystectomy in patients over 80 years old to determine whether the long-term mortality rate is higher than the reported recurrence rate. If so, this age group could benefit from a more conservative approach, such as antibiotic treatment or cholecystostomy. Therefore, the aim of this study was to evaluate the factors associated with 2 years survival after laparoscopic cholecystectomy in patients over 80 years old.
METHODS: We conducted a retrospective observational cohort study. We included all patients over 80 years old who underwent laparoscopic cholecystectomy. Survival analysis was conducted using the Kaplan‒Meier method. Cox regression analysis was implemented to determine potential factors associated with mortality at 24 months.
RESULTS: A total of 144 patients were included in the study, of whom 37 (25.69%) died at the two-year follow-up. Survival curves were compared for different ASA groups, showing a higher proportion of survivors at two years among patients classified as ASA 1-2 at 87.50% compared to ASA 3-4 at 63.75% (p = 0.001). An ASA score of 3-4 was identified as a statistically significant factor associated with mortality, indicating a higher risk (HR: 2.71, CI95%:1.20-6.14).
CONCLUSIONS: ASA 3-4 patients may benefit from conservative management due to their higher risk of mortality at 2 years and a lower probability of disease recurrence.
METHODS: We conducted a retrospective observational cohort study. We included all patients over 80 years old who underwent laparoscopic cholecystectomy. Survival analysis was conducted using the Kaplan‒Meier method. Cox regression analysis was implemented to determine potential factors associated with mortality at 24 months.
RESULTS: A total of 144 patients were included in the study, of whom 37 (25.69%) died at the two-year follow-up. Survival curves were compared for different ASA groups, showing a higher proportion of survivors at two years among patients classified as ASA 1-2 at 87.50% compared to ASA 3-4 at 63.75% (p = 0.001). An ASA score of 3-4 was identified as a statistically significant factor associated with mortality, indicating a higher risk (HR: 2.71, CI95%:1.20-6.14).
CONCLUSIONS: ASA 3-4 patients may benefit from conservative management due to their higher risk of mortality at 2 years and a lower probability of disease recurrence.
摘要：
背景：腹腔镜胆囊切除术是良性胆道疾病患者的首选治疗方法。有必要评估80岁以上患者腹腔镜胆囊切除术后的生存率，以确定长期死亡率是否高于报告的复发率。如果是,这个年龄组可以从更保守的方法中受益，如抗生素治疗或胆囊造口术。因此,本研究的目的是评估80岁以上患者腹腔镜胆囊切除术后2年生存率的相关因素.
方法：我们进行了一项回顾性观察性队列研究。我们包括所有80岁以上接受腹腔镜胆囊切除术的患者。使用Kaplan-Meier方法进行生存分析。进行Cox回归分析以确定与24个月时死亡率相关的潜在因素。
结果：总共144名患者被纳入研究，其中37人（25.69％）在两年的随访中死亡。比较不同ASA组的生存曲线，显示在被分类为ASA1-2的患者中,两年存活的比例较高,为87.50%,而ASA3-4为63.75%(p=0.001).ASA评分3-4分被确定为与死亡率相关的统计学显著因素。表明风险较高（HR：2.71，CI95%：1.20-6.14）。
结论：ASA3-4例患者可从保守治疗中获益，因为他们2年死亡风险较高，疾病复发概率较低。
方法：我们进行了一项回顾性观察性队列研究。我们包括所有80岁以上接受腹腔镜胆囊切除术的患者。使用Kaplan-Meier方法进行生存分析。进行Cox回归分析以确定与24个月时死亡率相关的潜在因素。
结果：总共144名患者被纳入研究，其中37人（25.69％）在两年的随访中死亡。比较不同ASA组的生存曲线，显示在被分类为ASA1-2的患者中,两年存活的比例较高,为87.50%,而ASA3-4为63.75%(p=0.001).ASA评分3-4分被确定为与死亡率相关的统计学显著因素。表明风险较高（HR：2.71，CI95%：1.20-6.14）。
结论：ASA3-4例患者可从保守治疗中获益，因为他们2年死亡风险较高，疾病复发概率较低。
