Correction to: Utilisation of an operative difficulty grading scale for laparoscopic cholecystectomy

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doi:10.1007/s00464-018-6377-8

Cited by 7 publications

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“…For example, prospective scoring of patient frailty, an increasingly recognised feature associated with poor postoperative outcomes, is lacking [7,33]. Thirdly, a precise scoring of intraoperative cholecystectomy difficulty is lacking [34,35]. Elderly patients often have gallstones for many years and features of chronic cholecystitis with the obliteration of the tissue planes in Calot's triangle and even chronic fistulation, such as Mirizzi syndrome [36] or cholecysto-enteric fistulation, which naturally lead to poorer patient outcomes [37].…”

Section: Discussionmentioning

confidence: 99%

Perioperative outcomes after laparoscopic cholecystectomy in elderly patients: a systematic review and meta-analysis

et al. 2020

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Background Laparoscopic cholecystectomy is increasingly performed in an ever ageing population; however, the risks are poorly quantified. The study aims to review the current evidence to quantify further the postoperative risk of cholecystectomy in the elderly population compared to younger patients. Method A systematic literature search of PubMed, EMBASE and the Cochrane Library databases were conducted including studies reporting laparoscopic cholecystectomy in the elderly population. A meta-analysis was reported in accordance with the recommendations of the Cochrane Library and PRISMA guidelines. Primary outcome was overall complications and secondary outcomes were conversion to open surgery, bile leaks, postoperative mortality and length of stay. Results This review identified 99 studies incorporating 326,517 patients. Increasing age was significantly associated with increased rates of overall complications (OR 2.37, CI95% 2.00–2.78), major complication (OR 1.79, CI95% 1.45–2.20), risk of conversion to open cholecystectomy (OR 2.17, CI95% 1.84–2.55), risk of bile leaks (OR 1.50, CI95% 1.07–2.10), risk of postoperative mortality (OR 7.20, CI95% 4.41–11.73) and was significantly associated with increased length of stay (MD 2.21 days, CI95% 1.24–3.18). Conclusion Postoperative outcomes such as overall and major complications appear to be significantly higher in all age cut-offs in this meta-analysis. This study demonstrated there is a sevenfold increase in perioperative mortality which increases by tenfold in patients > 80 years old. This study appears to confirm preconceived suspicions of higher risks in elderly patients undergoing cholecystectomy and may aid treatment planning and informed consent.

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Section: Discussionmentioning

confidence: 99%

Perioperative outcomes after laparoscopic cholecystectomy in elderly patients: a systematic review and meta-analysis

et al. 2020

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“…What is being sought, however, is to figure out what is the most appropriate time at which to intervene surgically in early cholecystectomy [ 91 ]. Surgical intervention on cholecystitis detected via laboratory test, but in the absence of symptoms, before secondary bacterial infection, will undoubtedly reduce the possibility of post-operative septic complications [ 92 , 93 ].…”

Section: Surgical Treatmentmentioning

confidence: 99%

Acute Cholecystitis from Biliary Lithiasis: Diagnosis, Management and Treatment

et al. 2023

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Biliary lithiasis is a global disorder affecting nearly 20% of the world’s population, although most cases occur without symptoms. Gallbladder stones could move into the common bile duct after gallbladder contraction, causing acute cholecystitis. The progression of the acute disease can take different forms, from mild inflammation, treatable with oral antibiotics, to the most severe forms with septic shock or biliary peritonitis, requiring specific treatment. Liver function tests and abdominal ultrasound are generally sufficient for diagnostic purposes. The most commonly used antibiotic is penicillin, with piperacillin achieving the best results; alternatively, fluoroquinolones could also be used, although there is no univocal consensus and surgery remains the only definitive treatment. A prolonged antibiotic therapy after cholecystectomy seems inadvisable, except in severe cases and/or in the immuno-compromised patient, where it should be periodically evaluated to avoid antibiotic resistance and unnecessary use. This review presents an evidence-based analysis to describe the advantages and disadvantages of the available options for the treatment of biliary lithiasis and cholecystitis, from the pathophysiological mechanisms behind lithiasis formation and also covering the main diagnostic findings for biliary stones, recommending an approach tailored to the patient’s characteristics and to the team’s expertise.

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“…ляопераційних ускладнень. Практично у всіх цих пацієнтів виникає потреба у корегувальній періопераційній консервативній терапії [3,4].…”

Section: General and Emergency Surgeryunclassified

The Age Factor in the Development of Perioperative Complications During the Surgical Treatment of Calculous Cholecystitis

Vasyliuk¹,

Bondariev²,

Vasyliuk³

et al. 2022

Khark. Surg. Sch.

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Summary. Elderly and senile patients in surgery are associated with numerous concomitant diseases, reduced functional reserve and high anesthetic risk. Aim. To assess the frequency and nature of perioperative complications in elderly and senile patients after laparoscopic cholecystectomy for acute or chronic calculous cholecystitis. Materials and methods. We analyzed the qualitative and quantitative characteristics of intraoperative and postoperative complications in 180 patients aged 60 to 90 years (elderly and senile) after laparoscopic cholecystectomy for acute or chronic calculous cholecystitis. The comparison group consisted of 200 patients aged 25 to 44 years. The procedure of choice in all patients was laparoscopic cholecystectomy. Results. In elderly and senile patients, intraoperative complications occurred more often (p<0.05) than in patients under 44 years of age. No significant differences were observed only in the frequency of intraoperative bleeding from the gallbladder artery, in the intrahepatic localization of the gallbladder, in the frequency of local peritonitis and gallbladder hydrops. In 20 (11.1 %) cases, there was a need for conversion (p=0.0002). Complications occurred in 29.4 % of cases, against 10.5 % in young patients (p<0.001). The difference in the number of minor complications: Clavien Dindo-1, Clavien Dindo-2 and Clavien Dindo-2a was improbable. Clavien Dindo-2b (5.0 %) (p<0.05), Clavien Dindo-3 (5.0 %) (p<0.05) and Clavien Dindo-4 (4.4 %) (p<0.05) complications occurred more often. Conclusions. Patients over 60 years of age are more likely (p<0.05) to have intraoperative problems during laparoscopic cholecystectomy and have a higher (p<0.05) risk of severe complications that require invasive procedures or may cause patient death.

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Correction to: Utilisation of an operative difficulty grading scale for laparoscopic cholecystectomy

Abstract: The list of the CholeS management group, Collaborators and Data Validators were omitted from the Acknowledgments.

Cited by 7 publications

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Perioperative outcomes after laparoscopic cholecystectomy in elderly patients: a systematic review and meta-analysis

Perioperative outcomes after laparoscopic cholecystectomy in elderly patients: a systematic review and meta-analysis

Acute Cholecystitis from Biliary Lithiasis: Diagnosis, Management and Treatment

The Age Factor in the Development of Perioperative Complications During the Surgical Treatment of Calculous Cholecystitis

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