A STUDY of 580 consecutive patients operated on for biliary-tract disease at the Massachusetts Memorial Hospitals, Boston, during the years 1944 to 1951, has revealed that 70 of these patients, representing 12% of the total, were 70 or more years of age. This was much higher than the 3.3% of such elderly patients noted in the report of gall-bladder surgery from the same hospital for the years 1924 through 19331 and appears to reflect not only increased longevity but also changing conditions of surgery in the 20-year interval.
Two-thirds of the 70 elderly patients in our series required operation because of involved biliary-tract problems. Such a finding is not surprising, since these old people generally shun elective cholecystectomy and consent to operation chiefly because of persistent pain or more serious manifestations.
The definitely higher incidence of postoperative morbidity noted in these elderly patients appeared to be due both to