Effect of multimodal prehabilitation on major outcomes of laparoscopic cholecystectomy after emergency percutaneous transhepatic gallbladder drainage in the elderly patients - A real-world based retrospective cohort study

Background: & aims: Multimodal prehabilitation is a new concept of preoperative management. We aimed to study the effectiveness of multimodal prehabilitation in the elderly patients who would receive laparoscopic cholecystectomy (LC) after emergency percutaneous transhepatic gallbladder drainage (PTGBD) . Methods This is a retrospective cohort study. Consecutive patients undergoing LC after emergency PTGBD between January 2020 to April 2021 were recruited. Patients over 70years old were treated by multimodal prehabilitation before LC including nutrition support, exercise and psychological interventions as prehabilitation group. Other patients were included as the control group. Perioperative parameters and outcomes were compared between groups. Results 43 cases were included in this research.24 cases were in the prehabilitation group. Comparing the prehabilitation and control groups, no statistical difference was detected in the laboratory examination before LC except hemoglobin and albumin. There were also no statistical difference in the rates of postoperative complications (8.33%vs.5.26%, P = 0.144) and conversion to open surgery (8.33%vs.5.26%, P = 0.144). Conclusion Multimodal prehabilitation could make the rate of major outcomes of LC after emergency PTGBD close to the young patients in the elderly patients.