{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T22:10:14Z","timestamp":1780351814192,"version":"3.54.1"},"reference-count":35,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2025,7,24]],"date-time":"2025-07-24T00:00:00Z","timestamp":1753315200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,7,24]],"date-time":"2025-07-24T00:00:00Z","timestamp":1753315200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["ANZ Journal of Surgery"],"published-print":{"date-parts":[[2025,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Older adults (\u2265\u200965\u2009years) present with complex Acute Gallstone Disease (AGD) and can deteriorate rapidly, necessitating time\u2010critical decision making. We describe AGD presentation, management, and associated outcomes in older adults.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Older adults with AGD between May 2021 and April 2022 were identified from a prospectively maintained dataset, including age, Clinical Frailty Scale (CFS) and co\u2010morbidities. Data pertaining to diagnosis, management, and outcomes (mortality, discharge destination, readmissions) were collected retrospectively.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Of 122 older adults with AGD, 63.1% were vulnerable or frail, 80.3% were moderately or severely co\u2010morbid, and 54.1% had Acute Calculous Cholecystitis (ACC). 43.9% were managed with antibiotics alone, 28.8% via Early Cholecystectomy (EC), 21.2% via Percutaneous Cholecystostomy (PC), 4.5% with Endoscopic Retrograde Cholangiography (ERCP), and 1.5% palliated. The EC cohort was less frail and less co\u2010morbid (CFS\u2009=\u20093, CCI\u2009=\u20093,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.05) compared to those managed non\u2010operatively. Inpatient mortality was 13.3% post\u2010PC and 0% post\u2010EC (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.03). 38.5% of those managed with antibiotics alone represented at 90\u2009days, as did 40% post\u2010PC. In contrast, post\u2010EC, 83.3% were discharged directly home, with 4.17% (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009\u2264\u20090.01) readmitted at 90\u2009days.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Older adults presenting with AGD have frailty and co\u2010morbidities, and ACC is the most frequent presentation. 28.8% of ACC was managed via EC, which was safe and effective, with &gt;\u200980% discharged home, &lt;\u20095% 90\u2010day readmissions, and no inpatient mortalities. Readmission was highest post PC and antibiotics. Frailty, co\u2010morbidities, procedural and anaesthetic risk, and associated clinical outcomes need to be considered when managing AGD in older adults.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/ans.70268","type":"journal-article","created":{"date-parts":[[2025,7,24]],"date-time":"2025-07-24T09:09:03Z","timestamp":1753348143000},"page":"1750-1757","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Management of Acute Gallstone Disease in Older Adults and Associated Outcomes"],"prefix":"10.1111","volume":"95","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1560-1162","authenticated-orcid":false,"given":"Kate","family":"Junker","sequence":"first","affiliation":[{"name":"Acute Surgical Unit Fiona Stanley Hospital  Perth Western Australia Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amanda","family":"Foster","sequence":"additional","affiliation":[{"name":"Acute Surgical 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