Perioperative Outcomes after Elective Laparoscopic Cholecystectomy in High Risk Patients

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Fazal Ur Rehman
Mujahid Zulfiqar Ali
Maheen Zafar
Madeeha Ikram
Aqsa Tassadduq
Muhammad Farrukh Habib


Background: The global population is aging, leading to an increased incidence of acute cholecystitis and associated complications in the elderly. While laparoscopic cholecystectomy is the gold standard for treating acute cholecystitis, its safety and outcomes in high-risk, elderly patients with comorbidities are not well-documented.

Objective: To compare postoperative complications, hospital stay duration, and nursing care requirements between high-risk elderly patients undergoing tube cholecystostomy versus early elective laparoscopic cholecystectomy for acute cholecystitis.

Methods: This cross-sectional comparative study was conducted at Combined Military Hospital Rawalpindi from July 2021 to January 2022. A total of 70 patients aged 40-80 years and classified as ASA 3 or 4 were included. Patients were divided into two groups: Group 1 (n=35) underwent tube cholecystostomy followed by interval cholecystectomy after six weeks; Group 2 (n=35) underwent early elective laparoscopic cholecystectomy within 72 hours of admission. Data on hospital stay, postoperative complications, and nursing care were collected and analyzed using SPSS version 25.0. Quantitative data were presented as mean ± standard deviation (SD), and qualitative data as frequency and percentage. Independent t-tests were applied, with a p-value of less than 0.05 considered statistically significant.

Results: In Group 1, 91% of patients had a hospital stay of less than 5 days compared to 11% in Group 2 (p=0.000). Group 1 had 94% of patients nursed in the ward/HDU, while 94% of Group 2 required ICU care (p=0.000). Postoperative complications were significantly lower in Group 1, with 97% having no complications compared to 34% in Group 2 (p=0.000). Only 3% of Group 1 required multidisciplinary team management versus 66% in Group 2.

Conclusion: Tube cholecystostomy is a safer and more effective initial management strategy for high-risk elderly patients with acute cholecystitis, leading to shorter hospital stays, less intensive postoperative care, and fewer complications compared to early elective laparoscopic cholecystectomy.

Article Details

How to Cite
Rehman, F. U., Ali, M. Z., Zafar, M., Ikram, M., Tassadduq, A., & Habib, M. F. (2024). Perioperative Outcomes after Elective Laparoscopic Cholecystectomy in High Risk Patients. Journal of Health and Rehabilitation Research, 4(2), 658–662.
Author Biographies

Fazal Ur Rehman, Combined Military Hospital Lahore Pakistan.

Resident Surgery, Combined Military Hospital Lahore, Pakistan.

Mujahid Zulfiqar Ali, Combined Military Hospital Lahore Pakistan.

Consultant Surgeon, Combined Military Hospital Lahore, Pakistan.

Maheen Zafar, Model Town Hospital Lahore Pakistan.

Consultant Ophthalmologist, Model Town Hospital Lahore, Pakistan.

Madeeha Ikram, Khan Research Laboratories Hospital Islamabad Pakistan.

Consultant Pediatrics, Khan Research Laboratories Hospital Islamabad, Pakistan.

Aqsa Tassadduq, District Headquarter Mirpur Pakistan.

Medical Officer, District Headquarter Mirpur, Pakistan.

Muhammad Farrukh Habib, Shifa Tameer-E-Millat University Islamabad Pakistan.

Department of Management Sciences, Shifa Tameer-E-Millat University Islamabad, Pakistan.


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