<bold>The aim of the study</bold> multicenter analysis of risc factors during 74 000 cholecystectomies to establish age dependent morbidity and transfusion rate.
<bold>Material and methods.</bold> Between 1th January 1993 and 31th December 1997, 74 049 patients overall in 178 surgical departments with the diagnoses of cholecystolithiasis or cholecystitis were included into a prospective database.
<bold>Results.</bold> The most frequently used method of cholecystectomy was the laparoscopic technique in patients up to 70 years of age. With increasing age, the proportion of laparotomy to laparoscopy procedures inverts; in patients over 70 years of age, open cholecystectomy was the most common method used. In the group of patients older than 90 years, 67.6% of patients were operated by laparotomy and 21.9% laparoscopically (conversion rate 3%).
In the age group of 41-50 years, less than 5% of cholecystectomies were performed as emergency cases. This proportion was increased with age continuously up to 46.2% in patients over 90 years of age. After elective cholecystectomy, the postoperative morbidity rate increased continuously from 5.3% to 21.7% in relationship to the patient age. In cases of emergency cholecystectomy, the morbidity rates were higher in all age groups ranging from 12.7% in patients between 31 and 40 years to 34.6% in patients over 90 years of age.
Mortality rates also increased continuously from 0.1% to 3.5% after elective cholecystectomy and from 2.9% up to 12.5% after emergency cholecystectomy depending on the age of the patient. The transfusion rate was 0% to 16.6%, increased with age from 0.8 to 5.5% in the cases of elective operations and from 3.8% to 16.6% in the cases of emargancy operations in erderly patients.
<bold>Conclusions.</bold> 1. The number of complication after elective cholecystectomies were low, increase it the case of emergency. 2. In the group of elderly patients laparotomy was done more frequently then laparoscopy. 3. The number of emergency operations increased in elderly patients. 4. The postoperative morbidity, mortality and transfusion rate increase in relationship to the patient age
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