2016 WSES guidelines on acute calculous cholecystitis

Ansaloni, Luca; Pisano, Michele; Catena, Fausto; Peitzmann, Andrew; Fingerhut, Abe; Catena, Fausto; Agresta, Ferdinando; Allegri, A; Bailey, Ian; Balogh, Zsolt J.; Bendinelli, Cino; Biffl, Walter L.; Bonavina, Luigi; Borzellino, Giuseppe; Brunetti, Francesco; Burlew, Clay Cothren; Camapanelli, G.; Campanile, Fabio Cesare; Ceresoli, Marco; Chiara, Osvaldo; Civil, Ian; Coimbra, Raúl; Moya, Mark De; Saverio, Salomone Di; Fraga, Gustavo Pereira; Gupta, Sanjay; Kashuk, Jeffry L.; Kelly, Michael D.; Koka, Venkata; Jeekel, Hans; Latifi, Rifat; Leppäniemi, Ari; Maier, Ronald V.; Marzi, Ingo; Moore, Frederick A.; Piazzalunga, Dario; Sakakushev, Boris; Sartelli, Massimo; Scalea, Thomas M.; Stahel, Philip F.; Taviloğlu, Korhan; Tugnoli, Gregorio; Uraneus, S.; Velmahos, George C.; Wani, Iftikhar H; Weber, Dieter; Viale, Pierluigi; Sugrue, Michael; Ivatury, Rao R.; Kluger, Yoram; Gurusamy, Kurinchi Selvan; Moore, Ernest E.

doi:10.1186/s13017-016-0082-5

Cited by 267 publications

(192 citation statements)

References 147 publications

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“…16 Due to advent of Laparoscopy and its advantages, the gold standard treatment for gallstones has shifted from Open to laparoscopic cholecystectomy and has been recommended by various surgical societies all over the world. 17,18 Hence, it is one of the commonly performed surgeries by beginner laparoscopic surgeons. Due to the natural history of the disease, various factors influence the outcome of this surgery.…”

Section: Discussionmentioning

confidence: 99%

A comprehensive review of the factors predicting technical difficulty in laparoscopic cholecystectomy

Menon¹

2017

Int Surg J

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Laparoscopic cholecystectomy is the most common laparoscopic procedure performed all over the world. It has now become the gold standard management for symptomatic gallstones. Aim of the study was to identify and highlight the predictive factors determining intra operative technical difficulty in laparoscopic cholecystectomy. A database search was done in Medline, Google scholar and Journal seek using keywords ‘Laparoscopic Cholecystectomy’, ‘difficult cholecystectomy’ and ‘predictive factors’. 54 abstracts were shortlisted out of which 15 were selected based on the time of publication (after 2005), size of study group, relevance to the title, level of evidence and the journal of publication. Results were compared and reviewed and the conclusion was reached. Fifteen papers were reviewed based on literature search and statistically significant variables predicting the technical difficulty in Laparoscopic cholecystectomy was found. These were age, sex, obesity, previous upper abdominal surgeries, comorbid diseases like Diabetes, acute cholecystitis, raised WBC counts, gall bladder wall thickness more than 3mm, presence of pericholecystitic collection, single impacted stone, multiple stones, contracted gall bladder, adhesions at Calot’s triangle, intrahepatic gall bladder, complications like gangrenous GB and fistulisation. The predictive risk factors reviewed here need to be kept in mind by the laparoscopic surgeon during a laparoscopic cholecystectomy. Though none of them is an absolute contraindication, presence of these factors demand modifications in technique for a safe laparoscopic surgery.

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Section: Discussionmentioning

confidence: 99%

A comprehensive review of the factors predicting technical difficulty in laparoscopic cholecystectomy

Menon¹

2017

Int Surg J

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“…Priporočila temeljijo na pregledu in analizi najnovejše literature, vanj so vključe-ne tudi japonske smernice. Priporočila se omejujejo na bolnike, ki so dobri kandidati za kirurško zdravljenje, še vedno pa ni jasno dorečeno, kako zdraviti bolnike z akutnim vnetjem žolčnika, ki so kritično bolni oziroma je pri njih kirurški poseg zelo tvegan (14,15).…”

Section: Klinična Razdelitevunclassified

“…Ni jasnih priporočil, kako obravnavati bolnike z visokim tveganjem za operacijo, prav tako ni dogovora, kako opredeliti tveganje za zaplete ob operaciji. Za bolnike s hudim tveganjem pride v poštev poskus konzervativnega zdravljenja ali perkutana holecistostoma (14,15).…”

Section: Kirurško Zdravljenjeunclassified

“…Po predlaganem algoritmu zdravljenja bolnikov za akutnim kalkuloznim holecistitisom Svetovnega združenja za urgentno kirurgijo se najprej oceni verjetnost sočasnih kamnov v skupnem žolčnem vodu (14,15). Verjetnost se oceni na osnovi klinične slike, UZ trebuha in vrednosti jetrnih encimov.…”

Section: Kirurško Zdravljenjeunclassified

“…Verjetnost se oceni na osnovi klinične slike, UZ trebuha in vrednosti jetrnih encimov. Pri majhni verjetnosti se priporoča zgodnja laparoskopska holecistektomija (14,15). Pri zmerni ali veliki verjetnosti se priporoča pred posegom endoskopski ultrazvok ali MRCP.…”

Section: Kirurško Zdravljenjeunclassified

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Akutno vnetje žolčnika – zgodnja operacija ali poskus konzervativnega zdravljenja?

Janež¹

2018

SlovMedJour

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IzvlečekAkutno vnetje žolčnika oziroma akutni holecistitis je pogosta bolezen, ki večkrat zahteva sprejem v bolnišnico in kirurško zdravljenje. Najpogosteje se pojavlja pri ljudeh, ki imajo žolčne kamne, pojavi pa se lahko tudi v odsotnosti žolčnih kamnov. Diagnozo akutnega holecistitisa postavimo na osnovi klinične slike, laboratorijskih izvidov in ultrazvoka trebuha. Algoritmi za bolnike, ki imajo akutno vnetje žolčnika brez pridruženih bolezni, so znani; odločitev za kirurški poseg pri bolnikih s pridruženimi boleznimi pa je odvisna od več dejavnikov. Laparoskopska holecistektomija je metoda izbire zdravljenja bolnikov z akutnim holecistitisom. Rezultati zdravljenja so bistveno boljši, kadar kirurški poseg napravimo znotraj 72 ur od nastopa kliničnih znakov.V prispevku so predstavljena najnovejša priporočila za obravnavo bolnikov z akutnim holecistitisom, povzeta po smernicah iz Tokia ter smernicah Svetovnega združenja za urgentno kirurgijo iz leta 2016 ter na koncu še izsledki in izkušnje nekaterih kliničnih študij in metaanaliz. AbstractAcute cholecystitis is a common disease, which often requires admission to hospital and surgical treatment. Acute cholecystitis is defined as inflammation of the gallbladder and usually occurs due to cystic duct obstruction from stones or sludge. It is a relatively common complication of gallstones, but it can also occur without gallstones. A combination of relevant clinical symptoms and ultrasound evidence is required to make a diagnosis of acute cholecystitis. Early surgery is recommended for all patients that are in good physical condition. There is still a debate how to treat high-risk and critically ill patients. Laparoscopic cholecystectomy is the method of choice for treatment of patients with acute cholecystitis. Early laparoscopic cholecystectomy should be done within 72 hours from the onset of symptoms. This article presents current guidelines according to the Tokyo guidelines and the World Society of Emergency Surgery guidelines, and at the end, experiences of some clinical trials. UvodAkutno vnetje žolčnika oziroma akutni holecistitis je pogosto bolezen, ki velikokrat zahteva bolnišnično zdravljenje in operacijo. Najpogosteje se pojavlja pri ljudeh z žolčnimi kamni, lahko pa tudi brez njih (1). Vnetje žolčnika brez prisotnosti kamnov je pogostejše pri kritično bolnih, ki so dlje časa na parenteralni prehrani, pri politravmatiziranih bolnikih, pri večjih opeklinah in pri bolnikih po srčnih operacijah (2). Akutni holecistitis je še posebej pogost vzrok

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Effectiveness of a quality improvement collaborative in reducing time to surgery for patients requiring emergency cholecystectomy

et al. 2019

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BackgroundAcute gallstone disease is a high‐volume emergency general surgery presentation with wide variations in the quality of care provided across the UK. This controlled cohort evaluation assessed whether participation in a quality improvement collaborative approach reduced time to surgery for patients with acute gallstone disease to fewer than 8 days from presentation, in line with national guidance.MethodsPatients admitted to hospital with acute biliary conditions in England and Wales between 1 April 2014 and 31 December 2017 were identified from Hospital Episode Statistics data. Time series of quarterly activity were produced for the Cholecystectomy Quality Improvement Collaborative (Chole‐QuIC) and all other acute National Health Service hospitals (control group). A negative binomial regression model was used to compare the proportion of patients having surgery within 8 days in the baseline and intervention periods.ResultsOf 13 sites invited to join Chole‐QuIC, 12 participated throughout the collaborative, which ran from October 2016 to January 2018. Of 7944 admissions, 1160 patients had a cholecystectomy within 8 days of admission, a significant improvement (P < 0·050) from baseline performance. This represented a relative change of 1·56 (95 per cent c.i. 1·38 to 1·75), compared with 1·08 for the control group. At the individual site level, eight of the 12 Chole‐QuIC sites showed a significant improvement (P < 0·050), with four sites increasing their 8‐day surgery rate to over 20 per cent of all emergency admissions, well above the mean of 15·3 per cent for control hospitals.ConclusionA surgeon‐led quality improvement collaborative approach improved care for patients requiring emergency cholecystectomy.

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2016 WSES guidelines on acute calculous cholecystitis

Cited by 267 publications

References 147 publications

A comprehensive review of the factors predicting technical difficulty in laparoscopic cholecystectomy

A comprehensive review of the factors predicting technical difficulty in laparoscopic cholecystectomy

Akutno vnetje žolčnika – zgodnja operacija ali poskus konzervativnega zdravljenja?

Effectiveness of a quality improvement collaborative in reducing time to surgery for patients requiring emergency cholecystectomy

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