To investigate the efficacy and safety of laparoscopic cholecystectomy in elderly patients.

Clinical data of 621 patients who underwent cholecystectomy for acute cholecystitis from January 2023 to December 2024 were retrospectively analyzed. Patients were divided into an elderly group (n=82, age ≥70 years) and a control group (n=539, age <70 years). Statistical analysis was performed using SPSS 22.0 software. Categorical data were analyzed using the χ² test or exact test. Normally distributed continuous data were presented as (

There were significant differences between the two groups in age, body mass index (BMI), ASA classification, comorbidities [cardiovascular disease, diabetes mellitus, chronic obstructive pulmonary disease (COPD), renal insufficiency], operation time, and length of hospital stay (P<0.05). The elderly group had higher incidences of postoperative pulmonary infection, intra-abdominal infection, and overall complications, as well as a longer postoperative hospital stay (P<0.05). The higher proportion of comorbidities (e.g., cardiovascular disease, diabetes mellitus) and poorer ASA classification in the elderly group may be important contributors to the increased incidence of postoperative pulmonary and intra-abdominal infections. Multivariate analysis showed that diabetes mellitus, ASA grade Ⅲ, and operation duration >80 minutes were independent risk factors for increased postoperative morbidity. Cardiovascular disease, chronic renal insufficiency, and length of hospital stay were factors independently associated with discharge rate.

Laparoscopic cholecystectomy is relatively safe in elderly patients under the premise of adequate evaluation of comorbidities and optimized perioperative management (such as blood glucose control and shortening operation time by an experienced surgical team). The risk of postoperative complications is acceptable.