Is my mother at 78 too old to have her gallbladder taken out? She keeps having attacks and the family is split

Posting about someone else for once. My mother is 78, lives alone, still does her own shopping, has blood pressure tablets and a dodgy knee and that is about it. Over the past four months she has had three of what I now recognise instantly as gallbladder attacks, the last one bad enough that she rang me at 1am.

She has seen a surgeon and the conversation was apparently about taking it out. My brother has decided this is madness at her age and keeps saying she should just avoid fatty food, and my mother, who does not like a fuss, is quietly siding with him because it is the option that involves nobody operating on her.

What I cannot find anywhere is whether age is actually a barrier here, or whether my brother has invented a rule. Has anyone here had a parent go through this, or gone through it themselves later in life? I do not want to bully her into surgery, I just want the family arguing about the right thing.

My aunt had hers out at 81. Straightforward keyhole, one night in, and she was pottering about within a fortnight. She was reasonably fit for her age, which I gather is the bit that matters more than the number.

Your mother doing her own shopping at 78 puts her in a different bracket from frail, in my very unmedical opinion.

The avoid fatty food plan is the part I would push back on hardest. It is not treatment, it is symptom dodging, and it does nothing to the stones. Plenty of people manage attacks that way for a while and then end up in hospital at 2am anyway, and having it done as an emergency is a rougher business than having it done on a planned list.

Not saying she should have surgery. Saying the choice is not really surgery versus a safe alternative.

That last point is the one I would want your brother to hear, and it is the reason this site exists at all. I spent a fortnight telling myself my attacks were something I ate, which is a milder version of the same reasoning, and it did not stop anything.

On your actual question, age on its own is not the deciding factor. Fitness for a general anaesthetic is, and that is assessed properly rather than guessed at from a birthday. Both sides of it are written up in gallbladder surgery at what age.

Your brother has not invented the concern, but he has turned it into a rule that does not exist. There is no age at which gallbladder surgery stops being offered. The operation is carried out across a wide age range, including in older and in frail patients, and the question that decides it is whether someone is fit enough for a general anaesthetic, which is worked out at a proper pre-operative assessment rather than inferred from the number of years.

Where age does matter is in the weighing, and it deserves stating plainly rather than glossed over. For a planned keyhole removal the risk of dying is low, on the order of 0.1% or less, and that figure is higher in emergency operations and in frail or older patients. Roughly 5 to 10% of keyhole operations are converted to an open operation, more often when the gallbladder is acutely inflamed or the anatomy is unclear, and an open operation means a longer stay, commonly a few days, and a recovery nearer 4 to 6 weeks rather than the 1 to 2 weeks that follows a straightforward keyhole removal. Recovery from any of that is generally harder at 78 than at 38, and for someone living alone that is a practical planning question as well as a medical one.

Set against that is what the alternative actually is. Avoiding fat manages symptoms; it does not remove stones or reduce the risk they carry. Once stones are causing repeated attacks the yearly risk of a complication such as an inflamed gallbladder, a blocked duct or pancreatitis runs at roughly 1 to 4%, and those events tend to arrive as emergencies, which is precisely the setting where operating on an older patient carries more risk. That comparison, planned versus emergency, is the real one, and it is set out in emergency versus planned gallbladder surgery.

The decision itself belongs to your mother and the surgeon who has examined her and knows her other conditions and her anaesthetic assessment. What a family can usefully do is make sure the choice being discussed is the true one, and that she goes to that appointment with her questions written down rather than her mind already made up by whoever spoke loudest at Sunday lunch.

Thank you. The planned versus emergency framing is what I was missing, and it is the one thing my brother has actually listened to, mostly because it is not me telling him he is wrong.

She has a follow up later this month and I am going with her. Her list of questions currently has four things on it, which is four more than last time.

Following this with real interest given where I have just been myself. The thing nobody tells you when you are choosing to wait is that you are not choosing between an operation and no operation, you are choosing when.