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Safety of Cholecystectomy in Nonagenarians: A Systematic Review and Meta-Analysis

Dimitrios Vouros, Belen Conde Inarejos, James Fowler, Sarthak Jain Orcid Logo, Vasileios Kotsarinis, Maaz Ullah, Awais Asif Chaudhary Orcid Logo, Martyn Charles Stott, Ahmad Hassan Orcid Logo, Shahin Hajibandeh Orcid Logo, SHAHAB HAJIBANDEH, Jacob Kadamapuzha, Thomas Satyadas

Geriatrics, Volume: 11, Issue: 3, Start page: 69

Swansea University Author: SHAHAB HAJIBANDEH

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DOI (Published version): 10.3390/geriatrics11030069

Abstract

Background/Objectives: To evaluate the safety of cholecystectomy in nonagenarians. Methods: In compliance with the PRISMA statement standards, a systematic review including random-effects meta-analysis and meta-regression models was conducted. All studies reporting postoperative outcomes in patients...

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Published in: Geriatrics
ISSN: 2308-3417
Published: MDPI AG 2026
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URI: https://cronfa.swan.ac.uk/Record/cronfa72171
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The risk of 30-day mortality was 5.4% (95% CI 3.1&#x2013;7.7); 30-day morbidity occurred in 22% (95% CI 11.3&#x2013;32.8). The mean length of hospital stay was 11.5 days (95% CI 8.3&#x2013;14.6). Postoperative mortality was not affected by male sex (coefficient: 0.028, p = 0.832), ASA status &#x2265; III (coefficient: 0.051, p = 0.309), cholecystitis as indication for cholecystectomy (coefficient: &#x2212;0.166, p = 0.051), cholecystectomy in emergency setting (coefficient: &#x2212;0.020, p = 0.425), laparoscopic (coefficient: &#x2212;0.104, p = 0.09) or open approach (coefficient: 0.104, p = 0.09), and conversion to open surgery (coefficient: 0.043, p = 0.820). The GRADE certainty of evidence was low to moderate. 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spelling 2026-06-26T11:51:56.5324804 v2 72171 2026-06-26 Safety of Cholecystectomy in Nonagenarians: A Systematic Review and Meta-Analysis b95fa4fe8ce5515ba689c728410200bd SHAHAB HAJIBANDEH SHAHAB HAJIBANDEH true false 2026-06-26 Background/Objectives: To evaluate the safety of cholecystectomy in nonagenarians. Methods: In compliance with the PRISMA statement standards, a systematic review including random-effects meta-analysis and meta-regression models was conducted. All studies reporting postoperative outcomes in patients aged ≥90 undergoing cholecystectomy were included and analyzed. Results: Six studies (1223 patients) were included. The risk of 30-day mortality was 5.4% (95% CI 3.1–7.7); 30-day morbidity occurred in 22% (95% CI 11.3–32.8). The mean length of hospital stay was 11.5 days (95% CI 8.3–14.6). Postoperative mortality was not affected by male sex (coefficient: 0.028, p = 0.832), ASA status ≥ III (coefficient: 0.051, p = 0.309), cholecystitis as indication for cholecystectomy (coefficient: −0.166, p = 0.051), cholecystectomy in emergency setting (coefficient: −0.020, p = 0.425), laparoscopic (coefficient: −0.104, p = 0.09) or open approach (coefficient: 0.104, p = 0.09), and conversion to open surgery (coefficient: 0.043, p = 0.820). The GRADE certainty of evidence was low to moderate. Conclusions: Subject to selection bias and confounding by fitness, the available evidence suggests that cholecystectomy in highly selected nonagenarians with good performance status, who have passed robust preoperative fitness assessment tests, may be safe with an acceptable risk of morbidity and mortality. Journal Article Geriatrics 11 3 69 MDPI AG 2308-3417 cholecystectomy; nonagenarians; mortality; morbidity; laparoscopy; robotic; open; emergency; elective; conversion; meta-analysis; meta-regression 8 6 2026 2026-06-08 10.3390/geriatrics11030069 Systematic Review COLLEGE NANME COLLEGE CODE Swansea University Another institution paid the OA fee 2026-06-26T11:51:56.5324804 2026-06-26T11:46:06.6673664 Faculty of Medicine, Health and Life Sciences Swansea University Medical School - Biomedical Science Dimitrios Vouros 1 Belen Conde Inarejos 2 James Fowler 3 Sarthak Jain 0009-0006-1289-0348 4 Vasileios Kotsarinis 5 Maaz Ullah 6 Awais Asif Chaudhary 0000-0001-5766-5124 7 Martyn Charles Stott 8 Ahmad Hassan 0000-0002-5281-6912 9 Shahin Hajibandeh 0000-0001-6159-1068 10 SHAHAB HAJIBANDEH 11 Jacob Kadamapuzha 12 Thomas Satyadas 13 72171__37059__7e705c5d76f54d2c8db9fd64ff6374a8.pdf 72171.VOR.pdf 2026-06-26T11:48:42.0321926 Output 2136250 application/pdf Version of Record true © 2026 by the authors. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license. true eng https://creativecommons.org/licenses/by/4.0/
title Safety of Cholecystectomy in Nonagenarians: A Systematic Review and Meta-Analysis
spellingShingle Safety of Cholecystectomy in Nonagenarians: A Systematic Review and Meta-Analysis
SHAHAB HAJIBANDEH
title_short Safety of Cholecystectomy in Nonagenarians: A Systematic Review and Meta-Analysis
title_full Safety of Cholecystectomy in Nonagenarians: A Systematic Review and Meta-Analysis
title_fullStr Safety of Cholecystectomy in Nonagenarians: A Systematic Review and Meta-Analysis
title_full_unstemmed Safety of Cholecystectomy in Nonagenarians: A Systematic Review and Meta-Analysis
title_sort Safety of Cholecystectomy in Nonagenarians: A Systematic Review and Meta-Analysis
author_id_str_mv b95fa4fe8ce5515ba689c728410200bd
author_id_fullname_str_mv b95fa4fe8ce5515ba689c728410200bd_***_SHAHAB HAJIBANDEH
author SHAHAB HAJIBANDEH
author2 Dimitrios Vouros
Belen Conde Inarejos
James Fowler
Sarthak Jain
Vasileios Kotsarinis
Maaz Ullah
Awais Asif Chaudhary
Martyn Charles Stott
Ahmad Hassan
Shahin Hajibandeh
SHAHAB HAJIBANDEH
Jacob Kadamapuzha
Thomas Satyadas
format Journal article
container_title Geriatrics
container_volume 11
container_issue 3
container_start_page 69
publishDate 2026
institution Swansea University
issn 2308-3417
doi_str_mv 10.3390/geriatrics11030069
publisher MDPI AG
college_str Faculty of Medicine, Health and Life Sciences
hierarchytype
hierarchy_top_id facultyofmedicinehealthandlifesciences
hierarchy_top_title Faculty of Medicine, Health and Life Sciences
hierarchy_parent_id facultyofmedicinehealthandlifesciences
hierarchy_parent_title Faculty of Medicine, Health and Life Sciences
department_str Swansea University Medical School - Biomedical Science{{{_:::_}}}Faculty of Medicine, Health and Life Sciences{{{_:::_}}}Swansea University Medical School - Biomedical Science
document_store_str 1
active_str 0
description Background/Objectives: To evaluate the safety of cholecystectomy in nonagenarians. Methods: In compliance with the PRISMA statement standards, a systematic review including random-effects meta-analysis and meta-regression models was conducted. All studies reporting postoperative outcomes in patients aged ≥90 undergoing cholecystectomy were included and analyzed. Results: Six studies (1223 patients) were included. The risk of 30-day mortality was 5.4% (95% CI 3.1–7.7); 30-day morbidity occurred in 22% (95% CI 11.3–32.8). The mean length of hospital stay was 11.5 days (95% CI 8.3–14.6). Postoperative mortality was not affected by male sex (coefficient: 0.028, p = 0.832), ASA status ≥ III (coefficient: 0.051, p = 0.309), cholecystitis as indication for cholecystectomy (coefficient: −0.166, p = 0.051), cholecystectomy in emergency setting (coefficient: −0.020, p = 0.425), laparoscopic (coefficient: −0.104, p = 0.09) or open approach (coefficient: 0.104, p = 0.09), and conversion to open surgery (coefficient: 0.043, p = 0.820). The GRADE certainty of evidence was low to moderate. Conclusions: Subject to selection bias and confounding by fitness, the available evidence suggests that cholecystectomy in highly selected nonagenarians with good performance status, who have passed robust preoperative fitness assessment tests, may be safe with an acceptable risk of morbidity and mortality.
published_date 2026-06-08T06:26:29Z
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