[Early operation of acute cholecystitis in advanced age]

In a 20-year period (1974-1993), 4230 patients underwent surgery of the gallbladder. Acute cholecystitis was the indication for emergency laparotomy in 869 patients (20.5%). Retrospective analysis demonstrated that after adjustment for age, sex, and mode of surgery--elective versus emergency--advanced age is not a risk factor contributing to mortality in uncomplicated cases of emergency surgery. Cases of acute cholecystitis complicated by perforation, peritonitis, and/or the presence of concrements in the biliary duct are associated with an increased mortality, however. We were able to demonstrate that advanced age is a risk factor in complicated cases and contributes to increased postsurgical mortality.