El interés del caso que presentamos radica en la presentación clínica de la agenesia de vena cava inferior como trombosis venosa de repetición. Creemos que ante todo paciente joven con clínica reiterativa de trombosis venosa profunda y sin factores de riesgo se debe realizar una TAC con el objetivo de identificar posibles alteraciones en el sistema venoso profundo.
Patients and methods. A retrospective study was made of 407 patients over 70 years of age who underwent elective or emergency surgery to treatment cholelithiasis over a four-year period. Age, sex, the number and type of organic constituents, the incidence of choledocholithiasis, intraoperative findings, surgical technique, histological findings, morbidity and mortality were recorded in each case.
Results. Elective surgery was performed in 233 patients and emergency surgery in 174. The mean patient age was 76.87 years in the former group and 77.35 years in the latter. Two members of the emergency surgery group underwent cholecystostomy under local anesthesia; 286 patients (62.89%) were subjected total cholecystectomy (126 patients in the emergency group and 130 in the elective group); and in 149 cases (36.6%), cholecystectomy was accompanied by bile duct involvement (46 emergency cases and 103 elective cases).
The rate of complications was 13.7% in the group that underwent elective surgery and 22.4% among the emergency cases (p < 0.05). The rates of mortality were 0.4% and 7.5%, respectively (p < 0.001).
Conclusion. The risks of elective cholecystectomy are relatively low, while those associated with emergency surgery are considerable greater. Thus, elderly patients with symptomatic gallstones should be considered candidates for early elective cholecystectomy.