ArticleWorld journal of emergency surgery : WJES2016
Geriatric Assessment as a qualification element for elective and emergency cholecystectomy in older patients.
Article in World journal of emergency surgery : WJES, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 3 of them syntheses that pooled it.
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Who cites it
12 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Frailty as a predictor of mortality and morbidity after cholecystectomy: A systematic review and meta-analysis of cohort studies.Langenbeck's archives of surgery · 2024Pooled it
- Frailty and Emergency Surgery: Results of a Systematic Review and Meta-Analysis.Frontiers in medicine · 2022Pooled it
- Perioperative outcomes after laparoscopic cholecystectomy in elderly patients: a systematic review and meta-analysis.Surgical endoscopy · 2020Pooled it
- Evaluation of thiol-disulfide homeostasis under low and standard pneumoperitoneum in elderly patients undergoing laparoscopic cholecystectomy: a prospective comparative study.European journal of medical research · 2025Trial
- Review
- Review
- Delayed Cholecystectomy After ERCP in Geriatric Patients: Balancing Surgical Risk and Recurrence Prevention - A Retrospective Study.Clinical interventions in aging · 2025Article
- Article
- Safety of Laparoscopic Cholecystectomy for Acute Cholecystitis in the Elderly: A Multivariate Analysis of Risk Factors for Intra and Postoperative Complications.Medicina (Kaunas, Lithuania) · 2021Article
- Does Preoperative Comprehensive Geriatric Assessment and Frailty Predict Postoperative Complications?World journal of surgery · 2020Article
- The Surgical Apgar Score and frailty as outcome predictors in short- and long-term evaluation of fit and frail older patients undergoing elective laparoscopic cholecystectomy - a prospective cohort study.Wideochirurgia i inne techniki maloinwazyjne = Videosurgery and other miniinvasive techniques · 2018Article
- 2017 WSES and SICG guidelines on acute calcolous cholecystitis in elderly population.World journal of emergency surgery : WJESReview
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundOlder patients experience a higher incidence of postoperative complications after cholecystectomy compared with younger patients. However, most studies have not considered patient frailty, particularly regarding emergency cholecystectomy. The aim of this prospective study was to evaluate outcomes in frail older patients eligible for elective and emergency cholecystectomy.
methodsPreoperative Geriatric Assessment (GA) was performed in consecutive patients aged 65+ years, operated for biliary disease. The GA evaluated the functional, cognitive, comorbidity, depressive, nutritional, and polypharmacy status and patients with two or more abnormal domains were considered frail. Outcomes of interest were 30-day postoperative mortality, morbidity, and length of hospital stay (LOS).
resultsA total of 126 patients (median age 74; range 65-93 years) were included. There was no difference between elective frail and non-frail patients regarding postoperative mortality (0 %) and morbidity (6 % vs. 5 %; p = 0.76). LOS was not significantly longer in the frail group (5.6 vs. 4 days; p = 0.22). In the emergency-admitted patients, almost all complications occurred in the frail population (mortality 5 % vs. 0 %; morbidity 36.7 % vs. 3.3 %, compared with non-frail patients, respectively; p < 0.01) and LOS was significantly longer (10.3 (frail) vs. 6 days (non-frail);p = 0.03). Frail status was a significant independent predictive factor for postoperative complications in the emergency population, only (odds ratio: 3.4 (1.2-9.7); p = 0.02).
conclusionsElective laparoscopic cholecystectomy is a safe and effective surgical technique also for older frail patients. In emergency settings, frail patients have significantly more complications and a longer LOS. However, the role of severity of frailty and the most reliable GA tools require further study.
trial registrationISRCTN14976998 (retrospectively registered).
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