Controlled Clinical Trial Comparing Early with Interval Cholecystectomy for Acute Cholecystitis

McArthur, Paul; Cuschieri, Alfred; Shields, R.; Sells, R. A.

doi:10.1177/003591577506801103

Cited by 23 publications

(20 citation statements)

References 2 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Patients with ACC presenting 72 h or more after the onset of symptoms are usually treated conservatively and subsequently readmitted for delayed LC 6-12 weeks later. About 25-29% of these patients require surgery before their scheduled delayed cholecystectomy because of treatment failure, recurrent attack of ACC or development of complications [6,7,14,15]. In these patients, inflammatory reactions including congestion, oedema, induration and adhesions at Calot's triangle make laparoscopic dissection extremely difficult in a significant proportion of patients, thus, increasing the morbidity related to bile duct injury [14].…”

Section: Discussionmentioning

confidence: 99%

“…For late presenting patients, most surgeons find LC too difficult and risky, preferring a conservative treatment followed by delayed LC, a few weeks later, after resolution of the acute episode. However, up to 30% of these patients require subsequent cholecystectomy before the scheduled date because of either failed response to conservative treatment or recurrent episodes of inflammation [6,7].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Laparoscopic Subtotal Cholecystectomy for Difficult Acute Calculous Cholecystitis

Abdallah¹

2017

View full text Add to dashboard Cite

Background: When the critical view of safety (CVS) can't be obtained during dissection of Calot's triangle in difficult gallbladder, conversion to open surgery or other "damage control" alternatives as cholecystostomy and subtotal cholecystectomy are recommended to prevent bile duct injury. Materials and methods: The medical records of all patients presented with acute calculous cholecystitis (ACC) during the study period were retrospectively reviewed and analyzed. Results: Laparoscopic cholecystectomy (LC) was attempted in 71 difficult gallbladders out of 379 patients presenting with ACC. In 6 patients (8.5%), conversion to open surgery or laparoscopic cholecystostomy was performed. Laparoscopic subtotal cholecystectomy (LSC) with dissection and control of the cystic duct was performed for the remaining 65 patients (91.5%) including 50 females (77%) and 15 males (23%) with a mean age of 42.35±12.4 years. The mean operative blood loss was 45.28±18.6 CC and the mean operative time was 96.3±24.19 minutes. There were no operative complications or mortality. The mean hospital stay was 28±17.8 hours. There was no postoperative jaundice, bile leak, intra-abdominal collections or mortality. Conclusion: When surgery is indicated for difficult ACC, LSC with control of the cystic duct is safe with excellent outcomes. However, if the CVS can't be achieved due to obscured anatomy at Calot's triangle, conversion to open surgery or cholecystostomy must be performed to prevent bile duct injury.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Laparoscopic Subtotal Cholecystectomy for Difficult Acute Calculous Cholecystitis

Abdallah¹

2017

View full text Add to dashboard Cite

show abstract

“…Patients with symptoms of acute cholecystitis will have recurrence of those symptoms and complications if they are not operated on, and urgent cholecystectomy is a safe and ef cient procedure for such patients (5,6,8,12,14,21). Increased use of urgent gallstone surgery as seen in this study therefore seems sensible.…”

Section: Discussionmentioning

confidence: 99%

“…Gallstone surgery is a major part of abdominal surgery for benign diseases, and demands considerable resources (1,9). During recent decades our knowledge about how to treat acute cholecystitis as well as nonacute gallstone disease has increased (5,6,8,12,14). Simultaneous progress in technology has made the ultrasonographic, laparoscopic, breoptic, and video equipment available for the diagnosis and treatment of gallstones (4,18).…”

Section: Introductionmentioning

confidence: 99%

Surgical Treatment of Gallstones: Changes in a Defined Population During a 20-year Period

Persson

Ros

Thulin

2002

The European Journal of Surgery

View full text Add to dashboard Cite

The decreasing rate of gallstone surgery noted between the 1970s and 1980s did not continue through the 1990s. Urgent surgery for gallstone disease has gradually become more common and now predominates over elective surgery in routine practice. The introduction of less traumatic surgical techniques contributed to the significant decrease in hospital stay after gallstone surgery. However, morbidity has not decreased and the diversification of surgical techniques used for treatment of gallstones requires continuous evaluation in routine practice.

show abstract

“…This is important in several respects. First, several reports have indicated that early planned surgery for the patient with acute cholecystitis can be undertaken safely (van der Linden and Sunzel, 1970; Sokhi and A. J. McKay et al Longland, 1973;McArthur et al, 1975). Conventional contrast radiology is inadequate in these patients (Raine and Gunn, 1975;Gagic et al, 1975), but there is a need for accurate diagnosis and the techniques of PTC and ERCP are invasive, carry a complication rate and are more difficult to perform, especially in very ill patients.…”

Section: Discussionmentioning

confidence: 99%

A prospective study of the clinical value and accuracy of grey scale ultrasound in detecting gallstones

McKay¹,

Duncan²,

Imrie³

et al. 1978

Journal of British Surgery

View full text Add to dashboard Cite

The accuracy and possible clinical value of grey scale ultrasonography in the detection of gallstones has been prospectively studied in 100 unselected patients presenting with recurrent biliary colic, acute cholecystitis or acute pancreatitis. Adequate visualization of the gallbladder was obtained in 79 cases, with 3 false positive and no false negative reports. Oral cholecystography remains the initial investigation of choice in patients presenting with recurrent biliary colic, but grey scale ultrasound has been shown in this study to be a reliable means of detecting gallstones in the 'acute' situation, when conventional contrast radiology is of limited value.

show abstract

Controlled Clinical Trial Comparing Early with Interval Cholecystectomy for Acute Cholecystitis

Cited by 23 publications

References 2 publications

Laparoscopic Subtotal Cholecystectomy for Difficult Acute Calculous Cholecystitis

Laparoscopic Subtotal Cholecystectomy for Difficult Acute Calculous Cholecystitis

Surgical Treatment of Gallstones: Changes in a Defined Population During a 20-year Period

A prospective study of the clinical value and accuracy of grey scale ultrasound in detecting gallstones

Contact Info

Product

Resources

About