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ORIGINAL RESEARCH article

Front. Surg.
Sec. Visceral Surgery
Volume 12 - 2025 | doi: 10.3389/fsurg.2025.1500700

One-year outcomes of elderly acute cholecystitis patients by index treatment

Provisionally accepted
Nuria Lluis Nuria Lluis 1,2*Celia Villodre Celia Villodre 3,4Lucía Guilabert Lucía Guilabert 4,5Isabel De Castro Isabel De Castro 4,5Pedro Zapater Pedro Zapater 4,5,6Belén Martínez Belén Martínez 4,5José R Aparicio José R Aparicio 4,5Fèlix Lluís Fèlix Lluís 4Enrique de-Madaria Enrique de-Madaria 4,5,6
  • 1 University of Pennsylvania, Philadelphia, United States
  • 2 Department of Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States
  • 3 Department of Surgery, Dr. Balmis General University Hospital, Alicante, Spain
  • 4 Alicante Health and Biomedical Research Institute, Alicante, Spain
  • 5 Dr. Balmis General University Hospital, Alicante, Spain
  • 6 Miguel Hernández University of Elche, Elche, Valencian Community, Spain

The final, formatted version of the article will be published soon.

    Background: Strategies for managing the elderly with acute cholecystitis need to be refined. Aims: To examine additional procedures, hospital readmissions, and outpatient visits in the year following the index admission. Patients and Methods: Single-institution retrospective study of fifty consecutive patients aged 70 years admitted with acute cholecystitis. A propensity score matching analysis adjusted for demographic and clinical variables was carried out. Results: The one-year rates of additional procedures were 0%, 47.4%, and 72.7% for surgery, supportive care (SC), and percutaneous gallbladder drainage (PCGD), respectively. The one-year readmission rate was 0%, 15.8%, and 50% after these index procedures, respectively. After propensity score analysis, patients who received SC (55.6% vs. 0%, P=.03) or PCGD (77.8% vs. 0%, P=.002) had a higher rate of additional procedures compared to those who underwent surgery. Additionally, patients receiving PCGD had a higher readmission rate than those undergoing surgery (55.6% vs 0%, P=.03). Nine patients who received SC and nine patients who received PCGD could have potentially undergone surgery during the index admission. This would have resulted in improved one-year outcomes. Conclusion: Cholecystectomy during the index hospitalization may provide better one-year outcomes than SC or PCGD in at least 50% of patients 70 years with acute cholecystitis.

    Keywords: Cholecystectomy, Laparoscopic*, Conservative Treatment / methods*, Drainage / methods, Endosonography / methods, Propensity Score, Retrospective Studies

    Received: 23 Sep 2024; Accepted: 06 Jan 2025.

    Copyright: © 2025 Lluis, Villodre, Guilabert, De Castro, Zapater, Martínez, Aparicio, Lluís and de-Madaria. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Nuria Lluis, University of Pennsylvania, Philadelphia, United States

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