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Acute cholecystitis in the elderly: a surgical emergency
Archives of Surgery (Chicago, Ill. : 1960)
|October 1, 1978
Summary
Elderly patients with acute cholecystitis have high complication rates and poor response to medical therapy. Prompt surgical intervention is crucial for managing this serious biliary tract disease in older men.
Area of Science:
- Gastroenterology
- Surgical Oncology
- Geriatric Medicine
Background:
- Biliary tract disease affects elderly male patients, presenting unique challenges.
- Acute cholecystitis is a common complication, often requiring intervention.
Purpose of the Study:
- To analyze the outcomes of elderly male patients with biliary tract disease.
- To identify complications and risk factors in acute cholecystitis within this demographic.
Main Methods:
- Retrospective review of 88 male patients over 60 with biliary tract disease.
- Analysis of patient demographics, diagnoses, treatments, and outcomes.
Main Results:
- Overall mortality was 6.8%; 40% had acute cholecystitis.
- Medical therapy failed in 97% of acute cholecystitis cases, necessitating surgery.
- Complications included gallbladder empyema (21%), gangrene/perforation (18%), and abscesses (15%).
- Escherichia coli and Klebsiella were common pathogens; anaerobes present in 25% of cultures.
- Delayed diagnosis/operation occurred in 33% due to subtle presentation and resuscitation needs.
Conclusions:
- Elderly patients with acute cholecystitis have a high risk of severe complications.
- Conservative management is often ineffective; prompt surgical intervention is vital.
- Early diagnosis and surgical control of infection are key to improving outcomes.