Is cholecystectomy necessary after endoscopic treatment of bile duct stones in patients older than 80 years of age?

Takaharu Yasui, Shunichi Takahata, Hiroshi Kono, Yosuke Nagayoshi, Yasuhisa Mori, Kosuke Tsutsumi, Yoshihiko Sadakari, Ohtsuka Takao, Masafumi Nakamura, Masao Tanaka

Research output: Contribution to journalArticle

21 Citations (Scopus)

Abstract

Background and aims: Although patients with cholecystocholedocholithiasis are generally referred to cholecystectomy after endoscopic sphincterotomy (ES) and common bile duct clearance, we often have a conflict whether cholecystectomy is necessary in very elderly patients with comorbid diseases. The aim of this study is to assess whether cholecystectomy in very elderly patients is justified after ES. Patients and methods: Patients with cholecystocholedocholithiasis who underwent ES and stone extraction and were followed-up for more than 10 years were retrospectively reviewed. We divided these patients into two groups: the elderly group (equal to or more than 80 years old) and young group (less than 80 years old) and compared late biliary complications and mortality. Results: The 10-year cumulative incidence of overall biliary complications was significantly lower in cholecystectomized patients than in patients with gallbladder in situ in the young group (7.5 vs. 21.7%, p = 0.0037), but not different in the elderly group (8.3 vs. 7.4%, p = 0.92). When each complication was evaluated separately, the rate of recurrent common bile duct stones (CBDS) was not different, but that of acute cholecystitis was significantly lower in the elderly group than in the young group (4.1 vs. 22.6%, p = 0.011). Conclusions: In very elderly patients the incidence of acute cholecystitis is low even when the gallbladder is preserved after endoscopic treatment of CBDS, with a similar risk of CBDS recurrence. Thus, it may not be necessary to recommend cholecystectomy after ES for CBDS in very elderly patients.

Original languageEnglish
Pages (from-to)65-70
Number of pages6
JournalJournal of Gastroenterology
Volume47
Issue number1
DOIs
Publication statusPublished - Jan 2012

Fingerprint

Cholecystectomy
Bile Ducts
Common Bile Duct
Endoscopic Sphincterotomy
Therapeutics
Acute Cholecystitis
Gallbladder
Incidence
Recurrence
Mortality

All Science Journal Classification (ASJC) codes

  • Gastroenterology

Cite this

Is cholecystectomy necessary after endoscopic treatment of bile duct stones in patients older than 80 years of age? / Yasui, Takaharu; Takahata, Shunichi; Kono, Hiroshi; Nagayoshi, Yosuke; Mori, Yasuhisa; Tsutsumi, Kosuke; Sadakari, Yoshihiko; Takao, Ohtsuka; Nakamura, Masafumi; Tanaka, Masao.

In: Journal of Gastroenterology, Vol. 47, No. 1, 01.2012, p. 65-70.

Research output: Contribution to journalArticle

Yasui, Takaharu ; Takahata, Shunichi ; Kono, Hiroshi ; Nagayoshi, Yosuke ; Mori, Yasuhisa ; Tsutsumi, Kosuke ; Sadakari, Yoshihiko ; Takao, Ohtsuka ; Nakamura, Masafumi ; Tanaka, Masao. / Is cholecystectomy necessary after endoscopic treatment of bile duct stones in patients older than 80 years of age?. In: Journal of Gastroenterology. 2012 ; Vol. 47, No. 1. pp. 65-70.
@article{99ae4ba217a24772a85bdb9613e28176,
title = "Is cholecystectomy necessary after endoscopic treatment of bile duct stones in patients older than 80 years of age?",
abstract = "Background and aims: Although patients with cholecystocholedocholithiasis are generally referred to cholecystectomy after endoscopic sphincterotomy (ES) and common bile duct clearance, we often have a conflict whether cholecystectomy is necessary in very elderly patients with comorbid diseases. The aim of this study is to assess whether cholecystectomy in very elderly patients is justified after ES. Patients and methods: Patients with cholecystocholedocholithiasis who underwent ES and stone extraction and were followed-up for more than 10 years were retrospectively reviewed. We divided these patients into two groups: the elderly group (equal to or more than 80 years old) and young group (less than 80 years old) and compared late biliary complications and mortality. Results: The 10-year cumulative incidence of overall biliary complications was significantly lower in cholecystectomized patients than in patients with gallbladder in situ in the young group (7.5 vs. 21.7{\%}, p = 0.0037), but not different in the elderly group (8.3 vs. 7.4{\%}, p = 0.92). When each complication was evaluated separately, the rate of recurrent common bile duct stones (CBDS) was not different, but that of acute cholecystitis was significantly lower in the elderly group than in the young group (4.1 vs. 22.6{\%}, p = 0.011). Conclusions: In very elderly patients the incidence of acute cholecystitis is low even when the gallbladder is preserved after endoscopic treatment of CBDS, with a similar risk of CBDS recurrence. Thus, it may not be necessary to recommend cholecystectomy after ES for CBDS in very elderly patients.",
author = "Takaharu Yasui and Shunichi Takahata and Hiroshi Kono and Yosuke Nagayoshi and Yasuhisa Mori and Kosuke Tsutsumi and Yoshihiko Sadakari and Ohtsuka Takao and Masafumi Nakamura and Masao Tanaka",
year = "2012",
month = "1",
doi = "10.1007/s00535-011-0461-3",
language = "English",
volume = "47",
pages = "65--70",
journal = "Journal of Gastroenterology",
issn = "0944-1174",
publisher = "Springer Japan",
number = "1",

}

TY - JOUR

T1 - Is cholecystectomy necessary after endoscopic treatment of bile duct stones in patients older than 80 years of age?

AU - Yasui, Takaharu

AU - Takahata, Shunichi

AU - Kono, Hiroshi

AU - Nagayoshi, Yosuke

AU - Mori, Yasuhisa

AU - Tsutsumi, Kosuke

AU - Sadakari, Yoshihiko

AU - Takao, Ohtsuka

AU - Nakamura, Masafumi

AU - Tanaka, Masao

PY - 2012/1

Y1 - 2012/1

N2 - Background and aims: Although patients with cholecystocholedocholithiasis are generally referred to cholecystectomy after endoscopic sphincterotomy (ES) and common bile duct clearance, we often have a conflict whether cholecystectomy is necessary in very elderly patients with comorbid diseases. The aim of this study is to assess whether cholecystectomy in very elderly patients is justified after ES. Patients and methods: Patients with cholecystocholedocholithiasis who underwent ES and stone extraction and were followed-up for more than 10 years were retrospectively reviewed. We divided these patients into two groups: the elderly group (equal to or more than 80 years old) and young group (less than 80 years old) and compared late biliary complications and mortality. Results: The 10-year cumulative incidence of overall biliary complications was significantly lower in cholecystectomized patients than in patients with gallbladder in situ in the young group (7.5 vs. 21.7%, p = 0.0037), but not different in the elderly group (8.3 vs. 7.4%, p = 0.92). When each complication was evaluated separately, the rate of recurrent common bile duct stones (CBDS) was not different, but that of acute cholecystitis was significantly lower in the elderly group than in the young group (4.1 vs. 22.6%, p = 0.011). Conclusions: In very elderly patients the incidence of acute cholecystitis is low even when the gallbladder is preserved after endoscopic treatment of CBDS, with a similar risk of CBDS recurrence. Thus, it may not be necessary to recommend cholecystectomy after ES for CBDS in very elderly patients.

AB - Background and aims: Although patients with cholecystocholedocholithiasis are generally referred to cholecystectomy after endoscopic sphincterotomy (ES) and common bile duct clearance, we often have a conflict whether cholecystectomy is necessary in very elderly patients with comorbid diseases. The aim of this study is to assess whether cholecystectomy in very elderly patients is justified after ES. Patients and methods: Patients with cholecystocholedocholithiasis who underwent ES and stone extraction and were followed-up for more than 10 years were retrospectively reviewed. We divided these patients into two groups: the elderly group (equal to or more than 80 years old) and young group (less than 80 years old) and compared late biliary complications and mortality. Results: The 10-year cumulative incidence of overall biliary complications was significantly lower in cholecystectomized patients than in patients with gallbladder in situ in the young group (7.5 vs. 21.7%, p = 0.0037), but not different in the elderly group (8.3 vs. 7.4%, p = 0.92). When each complication was evaluated separately, the rate of recurrent common bile duct stones (CBDS) was not different, but that of acute cholecystitis was significantly lower in the elderly group than in the young group (4.1 vs. 22.6%, p = 0.011). Conclusions: In very elderly patients the incidence of acute cholecystitis is low even when the gallbladder is preserved after endoscopic treatment of CBDS, with a similar risk of CBDS recurrence. Thus, it may not be necessary to recommend cholecystectomy after ES for CBDS in very elderly patients.

UR - http://www.scopus.com/inward/record.url?scp=84857631838&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84857631838&partnerID=8YFLogxK

U2 - 10.1007/s00535-011-0461-3

DO - 10.1007/s00535-011-0461-3

M3 - Article

VL - 47

SP - 65

EP - 70

JO - Journal of Gastroenterology

JF - Journal of Gastroenterology

SN - 0944-1174

IS - 1

ER -