Managing Gallstone Disease in the Elderly

Authors

Ankit Chhoda, Department of Internal Medicine, Bridgeport Hospital, Yale New Haven Hospital System, 267 Grant Street Bridgeport, CT, USA.
Saurabh S. Mukewar, Advanced Endoscopy, Division of Gastroenterology & Hepatology, Weill Cornell Medicine, 1283 York Avenue, 9th Floor, New York, NY 10065, USA.
SriHari Mahadev, Advanced Endoscopy, Division of Gastroenterology & Hepatology, Weill Cornell Medicine, 1283 York Avenue, 9th Floor, New York, NY 10065, USA. Electronic address: srm9005@med.cornell.edu.

Document Type

Article

Publication Title

Clinics in geriatric medicine

Abstract

Geriatric patients tend to have subtle presentations of biliary disorders and, if untreated, can decompensate acutely. Each biliary disorder warrants formulation of an individualized treatment plan with a multidisciplinary approach. Acute cholecystitis, a common complication of gallstones, is initially managed by conservative measures and subsequently, among patients with optimal surgical risk, through laparoscopic or open cholecystectomy. High-risk patients undergo temporization, percutaneous or endoscopic, followed by definitive intervention. Acute cholecystitis with complications (ie, perforation, gangrene, or small bowel obstruction) warrants emergent cholecystectomy. Gallstone migration into the biliary system can cause choledocholithiasis, often complicated by biliary pancreatitis or cholangitis if not intervened. Therapy for choledocholithiasis is based on biliary clearance through endoscopic and, infrequently, surgical approaches.

First Page

43

Last Page

69

DOI

10.1016/j.cger.2020.08.005

Publication Date

2-1-2021

Recommended Citation

Chhoda, Ankit; Mukewar, Saurabh S.; and Mahadev, SriHari, "Managing Gallstone Disease in the Elderly" (2021). All Research. 118.
https://scholar.bridgeporthospital.org/all_research/118

Identifier

33213774 (pubmed); 10.1016/j.cger.2020.08.005 (doi); S0749-0690(20)30061-6 (pii)