Abstract: Objective To study the Clinical observation of laparoscopic cholecystectomy under different time windows in the treatment of acute cholecystitis in the elderly.
Methods The clinical data of 72 patients with acute cholecystitis in our hospital in recent years were analyzed retrospectively.According to the different operation time，they were divided into three groups：early group（≤3d），middle group ＞3d and ≤7d）and late group（＞7d），24 cases in each group，all of them underwent laparoscopic cholecystectomy，The perioperative indexes and postoperative complications of the three groups were compared，and the stress indexes and immune function of the three groups before and after operation were compared.
Results The operation time，intraoperative bleeding volume，first anal exhaust time，first time out of bed after operation and hospitalization time of the three groups were significantly different ，early group < metaphase group < late group（P<0.05）.The level of C-reactive protein（CRP）in the three groups after operation was lower than that in the early group，early group < metaphase group < late group（P<0.05）.The levels of IgA，IgG and IgM in the three groups were significantly higher than those in the early group，the middle group and the late group，early group > middle group > late group（P<0.05）.The total incidence of complications in early group，middle group and late group were 16.67%，29.17% and 37.50%，respectively，with no significant difference（P>0.05）.
Conclusion Early laparoscopic cholecystectomy in patients with acute cholecystitis can reduce the amount of bleeding，reduce the body's stress response，and speed up the recovery of patients.

Key words: elderly； different time windows, laparoscopic cholecystectomy, acute cholecystitis