Early Surgery for Acute Cholecystitis in the Elderly: Getting it Right the First Time

Acute cholecystitis is one of the most common surgical emergency presentations globally. In the USA alone, over 300.000 patients per year present to the emergency department with acute cholecystitis. The condition is more likely to occur with increasing age. In the past, a ‘three-day window’ was referred to as the safety zone in which one could perform an emergency cholecystectomy. Recent guidelines suggest that this time window can be extended up to 7 days and even within 10 days from the onset of symptoms [ 1 ]. Of note, the most recent World Society of Emergency Surgery (WSES) guideline states that: “ Early laparoscopic cholecystectomy (ELC) should be the standard of care whenever possible, even in subgroups of patients who are considered fragile, such as the elderly; those with cardiac disease, renal disease, and cirrhosis; or those who are generally at high risk for surgery ” [ 1 ].