The impact of dementia on surgical outcomes of laparoscopic cholecystectomy for symptomatic cholelithiasis and acute cholecystitis: A retrospective study.

Introduction: The aim of this study was to clarify the impact of dementia on surgical outcomes of laparoscopic cholecystectomy for symptomatic cholelithiasis and acute cholecystitis. Methods: We reviewed medical data of 96 patients who underwent laparoscopic cholecystectomy for symptomatic cholecystitis and acute cholecystitis. The patients were divided into the dementia group (n = 18) and non‐dementia group (n = 78). Clinical features of the patients and surgical outcomes were compared between the two groups. Results: Mean age and rates of The American Society of Anesthesiologists Physical Status classification score > 2 in the dementia group were significantly higher than those of the non‐dementia group (P <.001, P =.008, respectively). Incidences of acute cholecystitis and the rate of percutaneous transhepatic gallbladder drainage in the dementia group were significantly higher than those of the non‐dementia group (P =.009, P =.01, respectively). The rates of conversion to laparotomy and non‐surgical complications in the dementia group were higher than those in the non‐dementia group (P =.02, P =.03, respectively). Postoperative hospital stay in the dementia group was significantly longer than that in the non‐dementia group (15.2 ± 9.3 vs 8.2 ± 3.2 days, P =.009). Subgroup analysis of patients with acute cholecystitis showed postoperative hospital stay in the dementia group to be significantly longer than that in the non‐dementia group (18.7 ± 10.7 vs 10.3 ± 4.2 days, P =.03). Conclusion: Patients with dementia who underwent laparoscopic cholecystectomy have a high incidence of acute cholecystitis and a high rate of percutaneous transhepatic gallbladder drainage, which may result in increased rates of conversion to laparotomy and prolong the postoperative hospital stay. [ABSTRACT FROM AUTHOR]