Conclusion : Early cholecystectomy seems to be a feasible treatment in elderly patients with acute cholecystitis .
Background : In the era of advanced surgical techniques and improved perioperative care , the willingness to perform emergency operations in elderly patients continues to increase .
This systematic review aim ed at assessing the clinical outcomes of early cholecystectomy in elderly patients with acute cholecystitis .
Acute cholecystitis in high-risk patients: percutaneous cholecystostomy vs conservative treatment
Abstract . Our objective was to compare the effectiveness of percutaneous cholecystostomy ( PC ) vs conservative treatment ( CO ) in high-risk patients with acute cholecystitis . The study was r and omized and comprised 123 high-risk patients with acute cholecystitis . All patients fulfilled the ultrasonographic criteria of acute inflammation and had an APACHE II score ≥12 .  Percutaneous cholecystostomy guided by US or CT was successful in 60 of 63 patients ( 95.2 % ) who comprised the PC group . Sixty patients were conservatively treated ( CO group ) . One patient died after unsuccessful PC ( 1.6 % ) . Resolution of symptoms occurred in 54 of 63 patients ( 86 % ) . Eleven patients ( 17.5 % ) died either of ongoing sepsis ( n=6 ) or severe underlying disease ( n=5 ) within 30 days . Seven patients ( 11 % ) were operated on because of persisting symptoms ( n=3 ) , catheter dislodgment ( n=3 ) , or unsuccessful PC ( n=1 ) . Cholecystolithotripsy was performed in 5 patients ( 8 % ) . Elective surgery was performed in 9 cases ( 14 % ) . No further treatment was needed in 32 patients ( 51 % ) . In the CO group , 52 patients ( 87 % ) fully recovered and 8 patients ( 13 % ) died of ongoing sepsis within 30 days . All successfully treated patients showed clinical improvement during the first 3 days of treatment . Percutaneous cholecystostomy in high-risk patients with acute cholecystitis did not decrease mortality in relation to conservative treatment . Percutaneous cholecystostomy might be suggested to patients not presenting clinical improvement following 3 days of conservative treatment , to critically ill intensive care unit patients , or to c and i date s for percutaneous cholecystolithotripsy
Conclusion : Early cholecystectomy seems to be a feasible treatment in elderly patients with acute cholecystitis .
Background : In the era of advanced surgical techniques and improved perioperative care , the willingness to perform emergency operations in elderly patients continues to increase .
This systematic review aim ed at assessing the clinical outcomes of early cholecystectomy in elderly patients with acute cholecystitis .