title: A retrospective comparison of older and younger adults undergoing early laparoscopic cholecystectomy for mild to moderate calculous cholecystitis.
abstract: OBJECTIVE
  To compare the demographic characteristics and intra- and postoperative outcomes in elderly adults (≥75) with those of younger adults undergoing early (<5 days after onset of complaints) cholecystectomy.
  
  
  METHODS
  Retrospective analysis from May 2010 to August 2012.
  
  
  METHODS
  Randomized, multicenter, clinical trial (ABCAL Study, NCT01015417).
  
  
  METHODS
  Individuals with mild or moderate acute calculous cholecystitis (ACC) according to the Tokyo Guidelines (N=414; n=78 aged 75-94, median 82; n=336 aged 18-74, median 49).
  
  
  METHODS
  Demographic characteristics and pre-, intra-, and postoperative data.
  
  
  RESULTS
  The elderly group was more likely to have an American Society of Anesthesiologists score of 3 or greater (62% vs 23%, P<.001), higher serum creatinine (103 vs 74 μmol/L, P<.001), and more-severe ACC (moderate ACC (62% vs 50%, P=.05), gangrenous cholecystitis (38% vs 15%, P=.001)) on preoperative imaging and confirmed intraoperatively. Ulcerated mucosa (76% vs 61%, P=.001) was significantly more frequent in the elderly group. Operative time, postoperative mortality, and postoperative infectious (18% vs 14%, P=.35) and noninfectious (9% vs 3%, P=.80) complications were similar between the two groups. Median length of stay (7.0 vs 5.0 days, P=.54) and readmission rate (15% vs 4%, P=.07) were not significantly higher in the elderly group. No significant difference was observed for the subgroup of participants aged 80 and older.
  
  
  CONCLUSIONS
  In this randomized trial that included a selected sample of older adults, there was no difference in major outcomes between elderly adults and their younger counterparts after early cholecystectomy. The findings are limited because important geriatric outcomes such as delirium and functional decline were not examined.
authors.affiliation: Department of Digestive Surgery, Amiens University Hospital, Amiens, France.|Department of Internal Medicine, Amiens University Hospital, Amiens, France.|Inserm U1088, Faculté de Médecine, Université de Picardie Jules Verne, Amiens, France.|Réseau d'Epidémiologie Clinique International Francophone, Amiens University Hospital, Amiens, France.
authors.forename: David
authors.initials: D
authors.lastname: Fuks
authors.affiliation: Department of Internal Medicine, Amiens University Hospital, Amiens, France.|Réseau d'Epidémiologie Clinique International Francophone, Amiens University Hospital, Amiens, France.
authors.forename: Pierre
authors.initials: P
authors.lastname: Duhaut
authors.affiliation: Department of Digestive Surgery, Beauvais Hospital, Beauvais, France.
authors.forename: Francois
authors.initials: F
authors.lastname: Mauvais
authors.affiliation: Department of Digestive Surgery, Lariboisière University Hospital, Paris, France.
authors.forename: Marc
authors.initials: M
authors.lastname: Pocard
authors.affiliation: Department of Digestive Surgery, Montreuil-sur-Mer Hospital, Rang-du-Fliers, France.
authors.forename: Vincent
authors.initials: V
authors.lastname: Haccart
authors.affiliation: Department of Digestive Surgery, Longjumeau Hospital, Longjumeau, France.
authors.forename: Jean-Christophe
authors.initials: JC
authors.lastname: Paquet
authors.affiliation: Department of Digestive Surgery, Montpellier University Hospital, Montpellier, France.
authors.forename: Bertrand
authors.initials: B
authors.lastname: Millat
authors.affiliation: Department of Digestive Surgery, Louis Mourier Hospital, Colombes, France.
authors.forename: Simon
authors.initials: S
authors.lastname: Msika
authors.affiliation: Department of Digestive Surgery, La Timone University Hospital, Marseille, France.
authors.forename: Igor
authors.initials: I
authors.lastname: Sielezneff
authors.affiliation: Department of Digestive Surgery, Rouen University Hospital, Rouen Cedex, France.
authors.forename: Michel
authors.initials: M
authors.lastname: Scotté
authors.affiliation: Department of Pathology, Amiens University Hospital, Amiens, France.
authors.forename: Denis
authors.initials: D
authors.lastname: Chatelain
authors.affiliation: Department of Digestive Surgery, Amiens University Hospital, Amiens, France.|Inserm U1088, Faculté de Médecine, Université de Picardie Jules Verne, Amiens, France.
authors.forename: Jean Marc
authors.initials: JM
authors.lastname: Regimbeau
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D017081:Cholecystectomy, Laparoscopic; D002764:Cholecystitis / Q000209:etiology* / Q000601:surgery*; D061345:Early Medical Intervention; D005260:Female; D042882:Gallstones / Q000150:complications* / Q000601:surgery*; D006801:Humans; D008297:Male; D012189:Retrospective Studies; D012720:Severity of Illness Index
keywords: acute calculous cholecystitis; cholecystectomy; elderly