Title: Acute cholecystitis in old adults: the impact of advanced age on the clinical characteristics
of the disease and on the surgical outcomes of laparoscopic cholecystectomy
Version: 2 Date: 05 Aug 2023
Reviewer's report:
General
I am grateful for the replies of the authors. That helps greatly in achieving a better comprehension
of their analysis.
I think the study results are interesting as they quantify the factors that increase the outcomes
of surgery in old adults with acute cholecystitis. Although aspects such the increased incidence
of gallbladder cancer and adverse surgical outcomes in the elderly are known, this large series
interprets patients’ characteristics and frames them into practical conclusions. Moreover, the
large study population allows to draw evidence-based remarks. Finally, I appreciate the authors’
comments on some potential study limitations, such as the selection bias. Nevertheless, I think
that can be overcome by the impact that results may have on the daily practice.
Below are some comments on specific sections of the study,  which would suggest minor
amendments to the text.
Other than that, I would be happy to recommend the publication of the study.
Title
Page 1, lines 1-2. Can the authors explain what “clinical characteristics” refer to? If they refer to
the clinical characteristics of AC, I would  suggest to rephrase the title i.e., “Acute cholecystitis
in old adults: the impact of advanced age on the clinical characteristics of the disease and on the
surgical outcomes of laparoscopic cholecystectomy”.
Background
Page 4, line 51. I would suggest to use “gallstones” instead of “gallbladder stones”.
Page 4, line 62. Can the authors clarify what “clinical characteristics” refer to? Is that clinical
characteristic of AC? if so, can they rephrase the sentence, please?
Results
Page 8, line 150. “…median interval from PTGBD to LC of 5 days.” Can the authors describe
the range (minimum and maximum n. of interval days), please?
Title: Acute cholecystitis in old adults: the impact of advanced age on the clinical characteristics
of the disease and on the surgical outcomes of laparoscopic cholecystectomy
Version: 2 Date: 05 Aug 2023
Reviewer's report:
General
I am grateful for the replies of the authors. That helps greatly in achieving a better comprehension
of their analysis.
I think the study results are interesting as they quantify the factors that increase the outcomes
of surgery in old adults with acute cholecystitis. Although aspects such the increased incidence
of gallbladder cancer and adverse surgical outcomes in the elderly are known, this large series
interprets patients’ characteristics and frames them into practical conclusions. Moreover, the
large study population allows to draw evidence-based remarks. Finally, I appreciate the authors’
comments on some potential study limitations, such as the selection bias. Nevertheless, I think
that can be overcome by the impact that results may have on the daily practice.
Below are some comments on specific sections of the study,  which would suggest minor
amendments to the text.
Other than that, I would be happy to recommend the publication of the study.
Title
Page 1, lines 1-2. Can the authors explain what “clinical characteristics” refer to? If they refer to
the clinical characteristics of AC, I would  suggest to rephrase the title i.e., “Acute cholecystitis
in old adults: the impact of advanced age on the clinical characteristics of the disease and on the
surgical outcomes of laparoscopic cholecystectomy”.
Background
Page 4, line 51. I would suggest to use “gallstones” instead of “gallbladder stones”.
Page 4, line 62. Can the authors clarify what “clinical characteristics” refer to? Is that clinical
characteristic of AC? if so, can they rephrase the sentence, please?
Results
Page 8, line 150. “…median interval from PTGBD to LC of 5 days.” Can the authors describe
the range (minimum and maximum n. of interval days), please?
Please review this paper.
user
Title: Acute cholecystitis in old adults: the impact of advanced age on the clinical characteristics
of the disease and on the surgical outcomes of laparoscopic cholecystectomy
Version: 2 Date: 05 Aug 2023
Reviewer's report:
General
I am grateful for the replies of the authors. That helps greatly in achieving a better comprehension
of their analysis.
I think the study results are interesting as they quantify the factors that increase the outcomes
of surgery in old adults with acute cholecystitis. Although aspects such the increased incidence
of gallbladder cancer and adverse surgical outcomes in the elderly are known, this large series
interprets patients’ characteristics and frames them into practical conclusions. Moreover, the
large study population allows to draw evidence-based remarks. Finally, I appreciate the authors’
comments on some potential study limitations, such as the selection bias. Nevertheless, I think
that can be overcome by the impact that results may have on the daily practice.
Below are some comments on specific sections of the study,  which would suggest minor
amendments to the text.
Other than that, I would be happy to recommend the publication of the study.
Title
Page 1, lines 1-2. Can the authors explain what “clinical characteristics” refer to? If they refer to
the clinical characteristics of AC, I would  suggest to rephrase the title i.e., “Acute cholecystitis
in old adults: the impact of advanced age on the clinical characteristics of the disease and on the
surgical outcomes of laparoscopic cholecystectomy”.
Background
Page 4, line 51. I would suggest to use “gallstones” instead of “gallbladder stones”.
Page 4, line 62. Can the authors clarify what “clinical characteristics” refer to? Is that clinical
characteristic of AC? if so, can they rephrase the sentence, please?
Results
Page 8, line 150. “…median interval from PTGBD to LC of 5 days.” Can the authors describe
the range (minimum and maximum n. of interval days), please?
assistant