Observational studyBMC surgery2026
MANagement of Gallstone disease in the Older patient (MANGO): clinical and quality of life outcomes from a prospective multicentre cohort study.
Observational study in BMC surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Authors and funding
7 authors.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundGallstones commonly cause emergency surgical admission in older adults and are frequently associated with complications. Although cholecystectomy is recommended in the general population, decision-making is complicated by increased comorbidity and frailty in older patients.
methodsTrainee-led prospective multicentre cohort across nine NHS hospitals. Consecutive emergency admissions in patients aged ≥ 70 years with radiologically confirmed gallstone disease were recruited (November 2022-March 2024). Data were collected at baseline, 30-days and 1-year, including Gastrointestinal Quality of Life Index (GIQLI) scores.
resultsOf 194 patients, 36 (18.6%) underwent emergency cholecystectomy, with 158 (81.4%) managed non-operatively at initial presentation. The non-operative group had greater comorbidity burden and frailty. All emergency operations were started laparoscopically (one conversion) with no major complications; median length of stay was similar (7 vs 5 days, p = 0.105). Gallstone-related readmission at 1-year was higher after non-operative management (23.0% vs 2.9%, p = 0.024); non-biliary readmissions were similar. One-year mortality was 12.4% vs 0% (p = 0.06). Baseline GIQLI was similar. At 30-days, emergency cholecystectomy was associated with the greatest difference in GIQLI score compared to the non-operative group (p ≤ 0.007). At 1-year, GIQLI remained higher after emergency cholecystectomy (123.8 vs 115.6, p = 0.039). Forty-three patients had undergone interval cholecystectomy by 1-year.
conclusionEmergency cholecystectomy in older patients deemed suitable for surgery is associated with reduced gallstone-related re-admissions at 1-year and higher QoL scores. These findings support consideration of surgery in appropriately selected older patients and further randomised research in this higher risk group.
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