Early laparoscopic cholecystectomy for acute cholecystitis: Does age matter?

Area of Science:

• Surgical outcomes
• Geriatric surgery
• Minimally invasive procedures

Background:

• Laparoscopic surgery and perioperative care have improved patient prognosis, particularly in older individuals.
• Acute calculous cholecystitis management in the elderly requires careful consideration of risks and benefits.

Purpose of the Study:

• To evaluate the safety and efficacy of early laparoscopic cholecystectomy for acute calculous cholecystitis in patients aged 75 years and older.
• To compare the outcomes of early laparoscopic cholecystectomy in older adult patients versus younger patients.

Main Methods:

• Retrospective analysis of 567 patients undergoing early laparoscopic cholecystectomy for acute calculous cholecystitis (January 2003 - July 2021).
• Comparison of outcomes between older adult patients (≥75 years) and younger patients.

Main Results:

• Older adults had higher rates of American Society of Anesthesiologists score ≥3 (37.5% vs 8.3%) and more severe acute calculous cholecystitis (grade II: 82.8% vs 67%).
• No significant differences were observed in operative time, conversion rates, intraoperative, or postoperative morbidity between the groups.
• Specific morbidities like bile duct injuries (1.6% vs 0%) and bile leakage (0% vs 1.2%) were not significantly different.

Conclusions:

• Early laparoscopic cholecystectomy is a safe option for older adult patients diagnosed with mild to moderate acute cholecystitis.
• The procedure demonstrates comparable safety and efficacy across different age groups for this condition.