29 days versus laparoscopic = 5.01 days; P < 0.001) resulting in lower hospital costs (open = $24, 060 versus laparoscopic = $12, 451;P < 0.001). Improved outcomes Tipifarnib clinical were also observed in patients ��80 years with respect to LOS (open = 11.91 versus laparoscopic = 6.77; P < 0.001) and hospital costs (open = $26, 342 versus laparoscopic = $15, 030;P < 0.001). In addition, among patients aged ��80 years, there was a significant increase in these patients being successfully discharged home directly from the hospital (open = 37.0% versus laparoscopic = 63.2%; P < 0.001). 4. Discussion Gallstone disease is the most common indication for abdominal surgery in the United States. Prevalence of gallstone disease is known to increase with age.
An increasing life expectancy means that, over the next several decades, the proportion of the population aged over 65 years is expected to rise from 12% to 20% resulting in more patients presenting with gallstone disease requiring surgery . Evaluating national trends to decipher the optimum surgical approach for these patients is important. This large cross-sectional study of hospitalized patients undergoing cholecystectomy found a steady increase in the adoption of laparoscopic cholecystectomy from 1999 to 2006 among all age groups. Although older patients clearly benefited from laparoscopic cholecystectomy than open cholecystectomy, they are significantly less likely than younger patients to undergo laparoscopic cholecystectomy. However, there was an increasing trend among elderly patients (65�C79 years and ��80 years) undergoing toward laparoscopic cholecystectomy over the study period.
Compared to younger patients, elderly patients experienced more adverse outcomes overall, but this was reduced with the adoption of laparoscopic surgery. This is important given that elderly patients tend to present with more complex biliary disease and multiple diagnoses that may increase their surgical risk . Elderly patients are also more likely to require further procedures such as cholecystostomy decompression, endoscopic retrograde cholangiopancreatography (ERCP), common bile duct exploration, and intraoperative cholangiogram [3, 4]. Among the elderly, laparoscopic cholecystectomy, compared with open cholecystectomy, is associated with lower mortality rates, surgical complications, LOS, hospital costs, and better discharge deposition overall, supporting laparoscopic cholecystectomy as the procedure of choice in this population.
In previous studies, the mortality rates in elderly patients undergoing laparoscopic Batimastat cholecystectomy are reported between 0 and 1% [6�C8]. However, these studies defined elderly as patients between the ages of 65 to 79 years only. In direct comparison, we observed a comparable mortality rate of 0.9% in the same age group. In our study cohort of patients aged ��80 years, the mortality rate was 2.