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 .
Systematic review of cholecystostomy as a treatment option in acute cholecystitis.
OBJECTIVES Percutaneous cholecystostomy ( PC ) is an established low-mortality treatment option for elderly and critically ill patients with acute cholecystitis . The primary aim of this review is to find out if there is any evidence in the literature to recommend PC rather than cholecystectomy for acute cholecystitis in the elderly population . METHODS In April 2007 , a systematic electronic data base search was performed on the subject of PC and cholecystectomy in the elderly population . After exclusions , 53 studies remained , comprising 1918 patients . Three papers described r and omized controlled trials ( RCTs ) , but none compared the outcomes of PC and cholecystectomy . A total of 19 papers on  mortality after cholecystectomy  in patients aged > 65 years were identified . RESULTS Successful intervention was seen in 85.6 % of patients with acute cholecystitis . A total of 40 % of patients treated with PC were later cholecystectomized , with a mortality rate of 1.96 % . Procedure mortality was 0.36 % , but 30-day mortality rates were 15.4 % in patients treated with PC and 4.5 % in those treated with acute cholecystectomy ( P < 0.001 ) . CONCLUSIONS There are no controlled studies evaluating the outcome of PC vs. cholecystectomy and the papers review ed are of evidence grade C. It is not possible to make definitive recommendations regarding treatment by PC or cholecystectomy in elderly or critically ill patients with acute cholecystitis . Low mortality rates after cholecystectomy in elderly patients with acute cholecystitis have been reported in recent years and therefore we believe it is time to launch an RCT to address this issue
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 .