Assessment of the optimal timing for early laparoscopic cholecystectomy in acute cholecystitis: a prospective study of the Club Coelio

Brunée, L; Hauters, P.; Closset, Jean; Fromont, G.; Puia-Negelescu, Serban; Coelio, Club

doi:10.1080/00015458.2018.1529344

Cited by 13 publications

(13 citation statements)

References 20 publications

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“…Esto no fue así en los pacientes con más de siete días de evolución, quienes tuvieron mayores tasas de complicaciones, tiempo quirúrgico, tiempo de estancia, dificultad del procedimiento y costos, y una tendencia a mayor tasa de conversión a cirugía abierta, aunque esta última no fue estadísticamente significativa. Los autores concluyeron y recomendaron que se debe considerar la intervención quirúrgica temprana en aquellos pacientes con menos de una semana de sintomatología 15 .…”

Section: Resultsunclassified

Controversias en el manejo de la colecistitis aguda tardía

et al. 2019

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La colecistitis aguda es la inflamación de la vesícula biliar, en la mayoría de los casos, explicada por la presencia de cálculos mixtos o de colesterol que producen obstrucción y desencadenan factores inflamatorios diversos. La colecistectomía por vía laparoscópica se ha convertido en su tratamiento estándar y definitivo. El procedimiento quirúrgico debe realizarse idealmente en las primeras 72 horas después de iniciados los síntomas, lo que habitualmente se denomina como cuadro agudo. Existe controversia sobre cuál es el manejo más adecuado cuando han pasado más de 72 horas del inicio de los síntomas, condición denominada ‘colecistitis aguda tardía’, cuando se considera que el proceso inflamatorio es mayor y, el procedimiento, técnicamente más complejo y peligroso. Para esta condición, se han establecido dos estrategias iniciales de manejo: la cirugía temprana –durante la hospitalización inicial– o el tratamiento conservador con antibióticos para la supuesta resolución completa de la inflamación, es decir, ‘enfriar el proceso’; varias semanas después, se practica una colecistectomía laparoscópica tardía –diferida o electiva–. Existen muchas publicaciones sobre ambas estrategias, en las que se exponen los beneficios y probables complicaciones de cada una; en la actualidad, se sigue debatiendo sobre el momento óptimo para practicar la intervención quirúrgica. Los trabajos más recientes y con mayor peso epidemiológico, resaltan los beneficios de la cirugía temprana pues, aunque las complicaciones intraoperatorias ocurren en las mismas proporciones, la cirugía en la hospitalización inicial reduce los costos, los reingresos y los tiempos hospitalarios. Después de revisar la literatura disponible a favor y en contra, este artículo pretende recomendar el procedimiento temprano, inclusive cuando hayan pasado más de tres días de iniciados los síntomas y, solo en casos muy seleccionados, diferir la cirugía.

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Section: Resultsunclassified

Controversias en el manejo de la colecistitis aguda tardía

et al. 2019

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“…Our results were not completely consistent with those of prior studies in which the current guidelines for 72h are based. [13,14] Most prior studies have evaluated the operative timing of LC using variables such as the length of hospital stay, operation time and expenditure, which are always determined by medical policy and the technical level of individual surgeons. Our study emphasized the selective role of clinical and pathological characteristics, such as the basic disease, age, and volume of the gallbladder.…”

Section: Discussionmentioning

confidence: 99%

“…[10] Some experts recommend that LCs should be performed 72 hours (72h) after the emergency symptoms, [11] They demonstrated that LCs performed within 72h are associated with decreased hospital stays, operation time, operative risk conversion rate and expenditures [9,12,13] whereas, over 72h, LCs become more difficult and less safe because of small artery vessel embolism and pathological changes. [9,14] Conversely, some studies assessing the timing of emergency LCs demonstrated no clinically relevant effect on conversion rates, operative times, or length of hospital stay according to the 72h criteria. [7,15] Furthermore, they found no significant differences in the operative difficulty between the early and delayed LC procedures.…”

Section: Introductionmentioning

confidence: 99%

Operative timing and the safety of emergency laparoscopic cholecystectomy: A retrospective analysis

Li,

Xu,

Tian

et al. 2023

Medicine

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The ideal operative timing for laparoscopic cholecystectomy (LC) remains controversial, particularly in emergency patients. This study aimed to evaluate the necessity of operative timing for emergency LC. One hundred ninety-four patients who had undergone operative timings were classified into groups of <72h and >72h from the onset of symptoms to the operation. Baseline data, basic disease, operative bleeding, complications, and conversion rates were analyzed by Variance analysis and logistic regression analysis. The total morbidity of postoperative complication was 4.93% and 3.84% (P = .751) in the <72h and >72h groups respectively. The complication and conversion to LC were mainly influenced by age and gallbladder volume (odds ratio [OR] = 1.078, P = .013, and OR = 1.035, P = .031), but not by operative timing (P = .292). The intraoperative blood loss was closely correlated with the gallbladder volume (OR = 1.019, P = .025) by logit regression analysis, and correlation coefficient of R = 0.436, P < .01. Our results suggest that it is not necessary to confine the operative timing of LC to within 72h from the onset of symptoms, and gallbladder volume should be emphasized in the operative timing for emergency LC.

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“…The continuing mucin production from the gallbladder's epithelium in combination with the impacted gallstone results in gallbladder distension and edema with acute inflammation. [3]. Acute cholecystitis is common indication for hospital admission and an increasing burden on the western healthcare system in the United States, the number of hospital admission for acute cholecystitis increased by 44% during 1997-2012, from 149661 to 21599 [4].…”

Section: Introductionmentioning

confidence: 99%

Evaluation of Laparoscopic Cholecystectomy in the Treatment of Early Acute Cholecystitis

2023

Al-Azhar University Journal of Virus Researches and Studies

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Acute cholecystitis is inflammation of gall bladder wall. Laparoscopic cholecystectomy has become the gold standard in the treatment of symptomatic gall stones. The aim of this work is to evaluate laparoscopic cholecystectomy in the treatment of early acute cholecystitis. Twenty patients were included in this study; this study is analytical prospective study; it was carried out on 20 patients presented with acute cholecystitis admitted in the general surgery department at AL-Zahraa University Hospital in the period from March 2021 to September 2021.All patients diagnosed as acute cholecystitis clinically followed by ultrasonography and laboratory data. Our study revealed that the mean age was (39.65 ± 11.31) and the range was( 18-57), female patients were 11 (55%) and male patients were 9 (45%), Murphy sign was +ve in 16(80%), fever was in 15(75%),leukocytosis in 9 (45%) there was intraoperative dense fibrous adhesions in 2(10%) , fibrinous adhesions in 9 (45%) and omentum only in 7 (35%) , intraoperative phlegmon in the form of omentum and bowel in 2 (10%) and the form of pyocele in 2 (10%) . intra operative decompression in 3(15%), intra operative spillage of GB content in 4(20%), there was conversion to open in 2(10%) and this was due to severe adhesions, postoperative fever in 2(10%). postoperative pain was mild in 18(90%) and moderate in 2(10%). Early laparoscopic cholecystectomy is safe, effective and feasible. It had no increase in operative time, perioperative complication.

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Assessment of the optimal timing for early laparoscopic cholecystectomy in acute cholecystitis: a prospective study of the Club Coelio

Cited by 13 publications

References 20 publications

Controversias en el manejo de la colecistitis aguda tardía

Controversias en el manejo de la colecistitis aguda tardía

Operative timing and the safety of emergency laparoscopic cholecystectomy: A retrospective analysis

Evaluation of Laparoscopic Cholecystectomy in the Treatment of Early Acute Cholecystitis

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