ThP4.1 - Benign biliary emergencies in the elderly: Does age influence the outcomes of index admission surgery and one session management of bile duct stones

Abstract Aim To study operative and postoperative outcomes of biliary emergencies in the elderly two age on a unit adopting index admission surgery and one session management of bile duct stones. Methods A prospective database of 6140 patients had 1089 (17.7%) over 60 years. Two age groups were analysed. Results Group I (60-69 years)N=530 (48.7%) Group II (over 70 years)N=559 (51.3%) Females 314 (59.2) 312 (55.8) Age Median 65 77 ASA 3 0r 4 174 (32.8) 236 (42.2) Presentations Acute cholecystitis 136 (25.6) 132 (23.7) Pancreatitis 96 (18.1) 97 (17.4) Jaundice/Cholangitis 218 (41.1) 323 (57.8) Ultrasound Bile duct dilatation 39 (7.4) 247 (44.2) Suspected CBD stones 388 (73.2) 461 (84.2) Preoperative ERCP 21 (3.9) 34 (6.1) Operative Acute/Empyema 147 (26.3) 160 (30.2) Difficulty Grading III 130 (24.5) 140 (25) IV 163 (30.7) 183 (32.7) V 29 (5.4) 46 (8.2) Difficult cystic pedicle 321 (6.5) 210 (37.5) Fundus first dissection 31 (5.8) 36 (6.4) Abnormal IOC 255 (48.1) 314 (56.2) Bile Duct Explorations 244 (46) 308 (55.1) Choledochotomy 74 (30.3) 153 (27.4) Choledochoscopy 186 (35.1) 261 (46.9) Biliary drains 98 (18.5) 167 (29.8) Operative time; median/range) 80 min/ 24-370 90 min/ 23-345 Open conversion 2 (0.37) 7 (1.25) Morbidity 63 (11.8) 40 (6.7) Readmissions 27 (5.1) 49 (8.7) Reoperations 3 (0.6) 4 (0.6) *Hospital stay; median 8 days 12 days Mortality 1 (0.2) 6 (1.1) *Resolved in one or two episodes 471 (88.8) 499 (90) *Including all previous and readmissions. BOLD : statistically significant Conclusions A policy of index admission surgery and one session management of bile duct stones is safe in the over 70s.