Teke Emre, Agca Birol, Güneş Yasin, Teke Gamze Nur, Yaz Ahmet Said, Aydin M Timucin, Başak Ahmet, Yıldırım Gülşah
General Surgery Department, University of Health Sciences, Gaziantep City Hospital, Gaziantep-Türkiye.
General Surgery Department, University of Health Sciences, Fatih Sultan Mehmet Training and Research Hospital, Istanbul-Türkiye.
Ulus Travma Acil Cerrahi Derg. 2025 Jan;31(1):59-65. doi: 10.14744/tjtes.2024.94489.
Acute cholecystitis (AC) is increasingly common and imposes a burden on healthcare systems, particularly in the elderly population. While laparoscopic cholecystectomy (LC) is the definitive treatment, percutaneous cholecystostomy (PC) is often preferred based on various factors. The treatment of elderly patients requires a multidisciplinary approach that carefully assesses surgical risks due to age-related changes and comorbidities. This retrospective study evaluates factors affecting mortality, morbidity, and hospital stay in elderly patients diagnosed with AC who presented to the emergency department and underwent PC.
This retrospective study, conducted between January 2013 and January 2021, included patients aged 70 years and older with grade 2 and 3 AC, as classified by the Tokyo Guidelines, who underwent PC. Data on laboratory parameters, comorbidities, and outcomes were collected and analyzed.
Among the 76 included patients, complications occurred in 7.9% of cases, with catheter replacement being the most common complication. In-hospital mortality was 5.2%. Factors influencing hospital stay included intervention timing and serum albumin levels. Placement of percutaneous cholecystostomy within the first three days of hospitalization has been shown to shorten the length of hospital stay.
Personalized treatment strategies are essential for managing AC in elderly patients. Early placement of PC may reduce hospital stays and associated costs. Further research and updated guidelines are necessary to optimize outcomes in this demographic group.
急性胆囊炎（AC）日益常见，给医疗系统带来负担，尤其是在老年人群体中。虽然腹腔镜胆囊切除术（LC）是确定性治疗方法，但基于各种因素，经皮胆囊造瘘术（PC）通常更受青睐。老年患者的治疗需要多学科方法，仔细评估因年龄相关变化和合并症导致的手术风险。本回顾性研究评估了急诊科就诊并接受PC的老年AC患者中影响死亡率、发病率和住院时间的因素。
本回顾性研究于2013年1月至2021年1月进行，纳入年龄在70岁及以上、根据东京指南分类为2级和3级AC且接受PC的患者。收集并分析了实验室参数、合并症和结局的数据。
在纳入的76例患者中，7.9%的病例发生并发症，导管置换是最常见的并发症。住院死亡率为5.2%。影响住院时间的因素包括干预时机和血清白蛋白水平。已证明在住院的前三天内进行经皮胆囊造瘘术可缩短住院时间。
个性化治疗策略对于老年AC患者的管理至关重要。早期放置PC可能会缩短住院时间和相关费用。需要进一步研究和更新指南以优化该人群的治疗效果。
