Invited Commentary: Optimization of the Management of Elderly Patients with Acute Complicated Calculous Biliary Disease is Feasible

The population aged over 65 years is progressively increasing worldwide. Calculous biliary disease is quite common, and its prevalence increases with age. The risk of developing complicated calculous biliary disease is also increased in patients over 65 years old. Current international guidelines (1) recommend admission laparoscopic cholecystectomy as the gold standard for the management of gallstone-related disease to prevent complications and recurrence, and at least one-third of elderly patients could present within two years after initial nonsurgical management (2). However, there is no specific statement regarding age. Although it is established that age is not a contraindication to surgical management (3), elderly patients undergo cholecystectomy less frequently than younger patients, mainly due to the increased prevalence of preexisting comorbidities in these patients and thus an increased risk of surgery-related complications. Dr. Bass and colleagues take the opportunity to closely evaluate the variations between centers and between individual surgeons regarding the global management of acute complicated calculous biliary disease and report it in an objective and informative manner with tangible data (4). …