{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T04:54:47Z","timestamp":1781672087105,"version":"3.54.5"},"reference-count":19,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2026,6,8]],"date-time":"2026-06-08T00:00:00Z","timestamp":1780876800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Geriatrics"],"abstract":"<jats:p>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 \u226590 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\u20137.7); 30-day morbidity occurred in 22% (95% CI 11.3\u201332.8). The mean length of hospital stay was 11.5 days (95% CI 8.3\u201314.6). Postoperative mortality was not affected by male sex (coefficient: 0.028, p = 0.832), ASA status \u2265 III (coefficient: 0.051, p = 0.309), cholecystitis as indication for cholecystectomy (coefficient: \u22120.166, p = 0.051), cholecystectomy in emergency setting (coefficient: \u22120.020, p = 0.425), laparoscopic (coefficient: \u22120.104, 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.<\/jats:p>","DOI":"10.3390\/geriatrics11030069","type":"journal-article","created":{"date-parts":[[2026,6,9]],"date-time":"2026-06-09T00:43:54Z","timestamp":1780965834000},"page":"69","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Safety of Cholecystectomy in Nonagenarians: A Systematic Review and Meta-Analysis"],"prefix":"10.3390","volume":"11","author":[{"given":"Dimitrios","family":"Vouros","sequence":"first","affiliation":[{"name":"Department of Hepatobiliary and Pancreatic Surgery, Manchester Royal Infirmary Hospital, Manchester M13 9WL, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Belen Conde","family":"Inarejos","sequence":"additional","affiliation":[{"name":"Department of Hepatobiliary and Pancreatic Surgery, Manchester Royal Infirmary Hospital, Manchester M13 9WL, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James","family":"Fowler","sequence":"additional","affiliation":[{"name":"Department of Hepatobiliary and Pancreatic Surgery, Manchester Royal Infirmary Hospital, Manchester M13 9WL, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-1289-0348","authenticated-orcid":false,"given":"Sarthak","family":"Jain","sequence":"additional","affiliation":[{"name":"Department of Hepatobiliary and Pancreatic Surgery, Manchester Royal Infirmary Hospital, Manchester M13 9WL, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vasileios","family":"Kotsarinis","sequence":"additional","affiliation":[{"name":"Department of Hepatobiliary and Pancreatic Surgery, Manchester Royal Infirmary Hospital, Manchester M13 9WL, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maaz","family":"Ullah","sequence":"additional","affiliation":[{"name":"Department of Hepatobiliary and Pancreatic Surgery, Manchester Royal Infirmary Hospital, Manchester M13 9WL, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5766-5124","authenticated-orcid":false,"given":"Awais Asif","family":"Chaudhary","sequence":"additional","affiliation":[{"name":"Department of Hepatobiliary and Pancreatic Surgery, Manchester Royal Infirmary Hospital, Manchester M13 9WL, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martyn Charles","family":"Stott","sequence":"additional","affiliation":[{"name":"Department of Hepatobiliary and Pancreatic Surgery, Manchester Royal Infirmary Hospital, Manchester M13 9WL, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5281-6912","authenticated-orcid":false,"given":"Ahmad","family":"Hassan","sequence":"additional","affiliation":[{"name":"Department of Hepatobiliary and Pancreatic Surgery, Manchester Royal Infirmary Hospital, Manchester M13 9WL, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6159-1068","authenticated-orcid":false,"given":"Shahin","family":"Hajibandeh","sequence":"additional","affiliation":[{"name":"Department of Hepatobiliary and Pancreatic Surgery, Queen Elizabeth Hospital, Birmingham B15 2GW, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shahab","family":"Hajibandeh","sequence":"additional","affiliation":[{"name":"Department of Hepatobiliary and Pancreatic Surgery, Manchester Royal Infirmary Hospital, Manchester M13 9WL, UK"},{"name":"Faculty of Medicine, Health and Life Science, Swansea University, Swansea SA2 8PP, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacob","family":"Kadamapuzha","sequence":"additional","affiliation":[{"name":"Department of Hepatobiliary and Pancreatic Surgery, Manchester Royal Infirmary Hospital, Manchester M13 9WL, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Satyadas","sequence":"additional","affiliation":[{"name":"Department of Hepatobiliary and Pancreatic Surgery, Manchester Royal Infirmary Hospital, Manchester M13 9WL, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,6,8]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"w14059","DOI":"10.4414\/smw.2014.14059","article-title":"General management of nonagenarian patients: A review of the literature","volume":"144","author":"Rivoirard","year":"2014","journal-title":"Swiss Med. 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