title: Early Cholecystectomy for Acute Cholecystitis in the Elderly Population: A Systematic Review and Meta-Analysis.
abstract: 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 aimed at assessing the clinical outcomes of early cholecystectomy in elderly patients with acute cholecystitis.
  
  
  METHODS
  Medline, Embase, and Cochrane Library databases were systematically searched for studies reporting on early cholecystectomy for acute cholecystitis in patients aged ≥70 years. The conversion rate, perioperative morbidity, and mortality were calculated using a random-effects model.
  
  
  RESULTS
  Eight articles fell within the scope of this study. In total, 592 patients were identified. The mean age was 81 years. Early cholecystectomy was performed laparoscopically in 316 patients (53%) and open in 276 patients (47%). The procedure was associated with a conversion rate of 23% (95% CI 18.6-28.3), a perioperative morbidity of 24% (95% CI 20.5-27.5), and a mortality of 3.5% (95% CI 2.3-5.4).
  
  
  CONCLUSIONS
  Early cholecystectomy seems to be a feasible treatment in elderly patients with acute cholecystitis. To reduce morbidity, patients who may benefit from surgery ought to be selected carefully. Future prospective studies should compare early cholecystectomy with alternative treatments to select the treatment that is most appropriate for elderly patients.
authors.affiliation: Department of Surgery, St. Antonius Hospital, Nieuwegein, The Netherlands.
authors.forename: Charlotte S
authors.initials: CS
authors.lastname: Loozen
authors.forename: Bert
authors.initials: B
authors.lastname: van Ramshorst
authors.forename: Hjalmar C
authors.initials: HC
authors.lastname: van Santvoort
authors.forename: Djamila
authors.initials: D
authors.lastname: Boerma
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D017081:Cholecystectomy, Laparoscopic / Q000009:adverse effects / Q000401:mortality; D041881:Cholecystitis, Acute / Q000601:surgery*; D061887:Conversion to Open Surgery; D006801:Humans; D007902:Length of Stay; D011183:Postoperative Complications; D013997:Time Factors; D016896:Treatment Outcome
keywords: Acute cholecystitis; Early cholecystectomy; Elderly