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Updated: Apr 14, 2026

Laparoscopic Cholecystectomy with Indocyanine Green Fluorescence: Choledochoscopic Stone Extraction and Primary Duct Suture
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Laparoscopic Cholecystectomy with Indocyanine Green Fluorescence: Choledochoscopic Stone Extraction and Primary Duct Suture

Published on: November 25, 2025

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Primary cholecystectomy is feasible in elderly patients with acute cholecystitis

Peter C Ambe1,2, Sebastian A Weber3, Hildegard Christ4

  • 1Department of Surgery II, Helios Klinikum Wuppertal, Witten/Herdecke University, Heusner Str. 40, 42283, Wuppertal, Germany. peter.ambe@helios-kliniken.de.

Aging Clinical and Experimental Research
|April 24, 2015
PubMed

Insights

Primary cholecystectomy is a feasible option for elderly patients with acute cholecystitis, showing comparable complication rates to younger patients. Age alone should not dictate surgical candidacy for acute cholecystitis.

Area of Science:

  • General Surgery
  • Gastroenterology
  • Geriatric Medicine

Background:

  • Acute cholecystitis management differs for elderly and severely ill patients.
  • Early cholecystectomy is standard for young, fit patients.
  • Primary cholecystectomy feasibility in elderly patients was investigated.

Purpose of the Study:

  • To compare outcomes of elderly patients undergoing surgery for acute cholecystitis.
  • To evaluate the safety and efficacy of primary cholecystectomy in older adults.
  • To challenge the notion that age is a sole contraindication for acute cholecystitis surgery.

Main Methods:

  • Retrospective comparison of elderly (≥70 years) and younger (<70 years) patients undergoing surgery for acute cholecystitis.
  • Analysis of outcomes including age at surgery, severity of cholecystitis, inflammatory markers, and surgical parameters.
  • Inclusion of 152 patients (74 elderly, 78 younger) from a German primary care center.

Main Results:

  • Elderly patients were significantly older at surgery (78 vs. 68 years).
  • Higher rates of severe cholecystitis, elevated WBC, CRP, and APACHE II scores were observed in the elderly group.
  • No significant differences in anesthesia/surgery duration or complication rates were found between groups; two mortalities (1.3%) occurred in the elderly group.

Conclusions:

  • Patient age is not the sole determinant for surgical fitness in acute cholecystitis.
  • Primary cholecystectomy can be safely performed in elderly patients with acute cholecystitis.
  • Outcomes suggest that comorbidities and overall health status are more critical than age alone.
Abstract

Keywords:
Acute cholecystitisCholecystectomyConversion to open surgeryElderly patientsLaparoscopic cholecystectomyPercutaneous cholecystotomy

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