Background : Acute cholecystitis is the major complication of biliary lithiasis. Cholecytectomy is gold standard gallbladder disease surgery. According to the 2015 Statistics Office, elderly poplulation is increasing. As life expectancy increases, awareness of the treatment of cholecystitis in the elderly is changing. The safety and feasibility of the cholecystectomy in octogenarians has been proved in many studies. Surgical treatment for cholecystitis should be considered in patients over 80 (Octagenarians) and even for over 90 years old. (Nonagenarians)

Methods : 393 patients, who are over 80 years and over 90 years diagnosed with aucte cholecystitis were performed cholecysctectomy between March 2012 and June 2020: 352 octagenerians and 41 nonagenerians. All patients were classified with Tokyo guideline. Parameter evaluated include, demographics, surgical outcome, ASA score and Tokyo guidline.

Results : All 393 patients were analyzed and we divided into two groups according to age, octagenerians (83.57?.64 years) and nonagenerians (92.98?.15 years). Survival rate was 97.7 to octagenerians and 97.6 to nonagenerians, so both groups had similar survival rates. Both groups were performed laparoscopic surgery(96.8% in octagenerians and 92.7% in nonagenerians) more than open surgery(3.2% in octagenerians and 7.3% in nonagenerians). Nonagenerians group operation time (74.63?0.83) was shorter than octagenerians group operation time (75.85?4.63). The incidence of postoperative complication in two groups were the following: pneumonia 5.7% and 7.3%, bleeding 1.7% and 2.4%, GI symptoms 6.0% and 2.4%, bile leakage 0.6% and 2.4%

Conclusions : According to our data, cholecystectomy is a safe and efficient procedure for the treatment of acute cholecystitis in patients both octagenerians and nonagenerians