Laparoscopic colecistectomy: anestesthetic implications in the elderly patient

Background The gallbladder stone is 20-40% of geriatric diseases. In elderly patients with limited cardiac reserve the pneumoperitoneum determines dangerous alterations of the cardiac output and other hemodynamic variables. The frequent co-morbidity in elderly people leads to a severe prognosis in these patients with surgical high mortality and morbidity rates in open surgery (1) otherwise the laparoscopic procedure is followed by lower mortality and morbidity rates (0-0.6% vs 1.4%). (2,3,4). The gradual abdominal insufflation to 12 mmHg followed by a limited 10 degree head-up tilt is associated with cardiovascular stability in elderly ASA III patients (5). The aim of our study was to analyze hemodynamic modifications during surgical treatment by laparoscopic colecistectomy and the anesthetic implications.