The Management of Acute Cholecystitis in Elderly Patients: Percutaneous Cholecystostomy versus Cholecystectomy

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Objective: Treatment of acute cholecystitis in eldery patients still remains controversial. Because of advanced age that can influence surgical results, less invasive managements have been performed in this population. The goal of this study was to analyze the results of cholecystectomy versus percu-taneous cholecystostomy for acute cholecystitis in elderly patients.Material and Method: Seventy four patients aged 65 years and older treated for acute cholecystitis were identified retrospectively from our medical records.Results: Of the 74 patients, 40 (54 %) underwent cholecystectomy, while 34 (46%) had a percutaneous cholecystostomy for AC as an initial treat-ment. The mean length of follow up was 28, 5±29, 3(1-35) months in percutaneous cholecystostomy and 12, 4±15 (1-42) months in cholecystectomy patients, respectively (p=0,0032). The success rate was significantly higher in cholecystectomy patients compared to percutaneous cholecystostomy patients (p=0,0210). Seventeen (50 %) patients who had PC subsequently underwent cholecystectomy. Readmission rates were higher in the percuta-neous cholecystostomy group (p=0, 0848). There was no statistically significant difference in the patient survival rate between the two groups (p=0,1799).Conclusion: This study confirms that cholecystectomy is a more effective treatment than percutaneous cholecystostomy for acute cholecystitis in elderly patient who is fit for surgery.

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Acute cholecystitis , Elderly , Percutaneous cholecystostomy , Cholecystectomy.

Fırat Medical Journal

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Fırat Medical Journal