Brief Answer: Cholecystectomy , conservative management Detailed Answer: Thank you for asking XXXX! Cholecystitis at old ages need admissions and management with Prophylactic antibiotic coverage with levofloxacin (Levaquin, 500 mg PO qd) and metronidazole (500 mg PO bid and antispasmodics like phloroglucinols and Antiemetics, such as oral/rectal promethazine (Phenergan) or prochlorperazine (Compazine), to control nausea and to prevent fluid and electrolyte disorders and pain management with oxycodone/acetaminophen (Percocet) or oxycodone/acetaminophen (Vicodin). Usually the standard procedure during the infection is to keep the patient Nil by mouth till the infectious weans off completely and then undergo a laparoscopic surgery for cholecystectomy. Surgical removal of the gallbladder is the best option here but as i can see the advanced age, cardiac history and diabetes and obesity as an apprehension to the outcomes. If that becomes the issue then you can have sonographically guided, percutaneous, transhepatic cholecystostomy under SAGES guidelines. Discuss the options with hepatobiliary surgeons and once you get a green signal from anesthesia and surgical department there is no better way than getting rid of the gallbladder. Diet and lifestyle modifications will demand losing weight as a top priority as fatty meals and cholesterols increase the odds for recurrence with involving pancreas too. Conservative management will be discussed if the surgical options are ruled out but surgical removal of gallbladder using minimal invasive techniques is the best option here. I hope it helps. Dont forget to close the discussion please. May the odds be ever in your favour. S Khan

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