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Background Cholecystectomy is one of the most commonly performed general surgical operations in the UK. Around 50,000 patients undergo cholecystectomy every year. Recently a meta-analysis has raised concerns regarding the increased risk of performing cholecystectomy in octogenarians. Therefore, a study was organised to assess the safety and outcomes of octogenarians undergoing cholecystectomy compared to patients aged 65-79. Methods This is a retrospective observational study of a prospective database of all cholecystectomies performed from January’15 to December’20, including patients aged≥65 (elective and emergency). Adjunct cholecystectomies and age&amp;lt;65 were excluded. Patients were divided into OCG (age&amp;gt;80) and UE (age 65-79) groups. The primary outcome was ‘30day mortality’ (TDM). Secondary outcomes were graded ‘post-operative complications’ (POC) based on ‘Clavien-Dindo Classification’ (CDC), Length of Stay (LoS) and the total number of ‘Intensive care unit’(ICU) admissions. The categorical and continuous variables were assessed using Chi-square and Mann-Whitney U’ test, respectively. A p &amp;lt; 0.05 was considered statistically significant. Results 587 patients were included in this cohort. Majority of the patients were in UE (87.2%,n=512 vs OCG-12.8%,n=75). There was one TDM noted in each group (UE-0.2%,n=1 vs OCG-1.3%,n=1; p = 0.11). Intervention requiring grade-3 CDC were significantly common in OCG (OCG-18.6%,n=14 vs UE-6.8%,n=35; p = 0.00054). However, grade-2 CDC complications were significantly common in UE (UE-16.6%,n=85 vs OCG-2.7%,n=2; p = 0.0015). Number of intensive care stay was similar between the groups (UE-0.9%,n=5 vs OCG-1.3%,n=1; p = 0.77). However, uncomplicated postoperative recovery (p = 0.91) and grade-4 CDS (p = 0.77) were comparable between the studied groups. Median LoS was 1-day in both groups with no statistical difference, p = 0.078. Conclusions This study demonstrates that cholecystectomy could be safely offered to a selective group of fit and well octogenarians. Octogenarians who had more complications requiring intervention may be due to factors comprising comorbidities and delayed presentation. However, the TDM and LoS of octogenarians were comparable to the control group. Therefore, age should not be considered as a solitary defining criterion in patient selection for cholecystectomy. Nevertheless, the retrospective nature of this study and skewed patient distribution are the limitations of the study.

P-BN23 Cholecystectomy in Octogenarians – Is there a benevolent bias?