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Acute cholecystitis in aged patients

J Prousalidis1, E Fahadidis, S Apostolidis

  • 1Department of Medicine, Aristotles University of Thessaloniki, AHEPA Hospital, Greece.

HPB Surgery : a World Journal of Hepatic, Pancreatic and Biliary Surgery
|January 1, 1996
PubMed
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This study analyzed 62 elderly patients with acute cholecystitis. Most cases were mild, with surgery recommended if initial antibiotic treatment for acute cholecystitis fails.

Area of Science:

  • Surgery
  • Geriatrics
  • Gastroenterology

Background:

  • Acute cholecystitis is a common condition, particularly in the elderly population.
  • Management strategies for acute cholecystitis in older adults require careful consideration due to potential comorbidities.
  • This study reviews outcomes of elderly patients treated over a 20-year period.

Purpose of the Study:

  • To analyze the treatment outcomes of acute cholecystitis in patients over 70 years of age.
  • To evaluate the effectiveness of conservative versus surgical management in this demographic.
  • To identify factors influencing outcomes in elderly patients with acute cholecystitis.

Main Methods:

  • Retrospective analysis of 62 patients aged 70+ with acute cholecystitis from 1970-1990.

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  • Patients were divided into Group A (antibiotic treatment) and Group B (conservative treatment followed by surgery).
  • Surgical procedures included cholecystostomy, cholecystectomy, and cholecystectomy with common bile duct exploration.

    • Main Results:

    • Mild clinical presentation was observed in 47 patients; severe in 15.
    • 14 patients (Group A) improved with antibiotics alone; 48 patients (Group B) required surgery after initial conservative management.
    • Surgical complications included gallbladder gangrene (10), choledocholithiasis (7), and choloperitoneum (7). Mortality was 1 in Group A and 3 in Group B.

    Conclusions:

    • Acute cholecystitis in the elderly often presents mildly.
    • Prompt surgical intervention after 2-3 days of failed medical treatment is recommended for acute cholecystitis in the aged.
    • Early surgical consultation and management are crucial for optimizing outcomes in elderly patients with acute cholecystitis.