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For patients with acute cholecystitis, early laparoscopic surgery is recommended, even for those with comorbid conditions. However, older patients with comorbidities often undergo percutaneous cholecystostomy because clinicians fear surgical complications. To address such concerns, investigators compared operative treatment versus nonoperative treatment during initial hospital stays for 32,000 U.S. Medicare patients (mean age, 79) with multimorbidity who presented to emergency departments (EDs) with acute cholecystitis.
In propensity-adjusted analyses, compared with nonoperative treatments (including cholecystostomy tube placement), operative treatment was associated with significantly lower 30- and 90-day mortality (risk difference, 3% and …