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 surgical patients: percutaneous cholecystostomy versus laparoscopic cholecystectomy (CHOCOLATE trial): Study protocol for a randomized controlled trial
Background Laparoscopic cholecystectomy in acute calculous cholecystitis in high risk patients can lead to significant morbidity and mortality .  Percutaneous cholecystostomy may be an alternative treatment option but the current literature does not provide the surgical community with evidence based advice . Methods / Design The CHOCOLATE trial is a r and omised controlled , parallel-group , superiority multicenter trial . High risk patients , defined as APACHE-II score 7 - 14 , with acute calculous cholecystitis will be r and omised to  laparoscopic cholecystectomy or percutaneous cholecystostomy . During a two year period 284 patients will be enrolled from 30 high volume teaching hospitals . The primary endpoint is a composite endpoint of major complications within three months following r and omization and need for re-intervention and mortality during the follow-up period of one year . Secondary endpoints include all other complications , duration of hospital admission , difficulty of procedures and total costs . Discussion The CHOCOLATE trial is design ed to provide the surgical community with an evidence based guideline in the treatment of acute calculous cholecystitis in high risk patients .Trial Registration Netherl and s Trial Register ( NTR ) :
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 .