How to Predict Postoperative Complications After Early Laparoscopic Cholecystectomy for Acute Cholecystitis: the Chole-Risk Score

Martino, Marcello Di; Mora-Guzmán, Ismael; Jodra, Víctor Vaello; Dehesa, A. Sanjuanbenito; García, D. Morales; Ruíz, R.; Nisa, Francisca García‐Moreno; Moreno, Fernando Mendoza; Batanero, S. Alonso; Sampedro, José E. Quiñones; Cumplido, Paola Lora; Bravo, A Arango; Rubio-Perez, Inés; Asensio-Gomez, Luis; Aranda, Fernando; Farrarons, Sara Sentí; Moreno, Cristina Ruiz; Moreno, Clara Maria Martinez; Lasarte, Aingeru Sarriugarte; Calvo, Mikel Prieto; Aparicio-Sánchez, Daniel; Pozo, Eduardo Perea del; Pellino, Gianluca; Martín-Pérez, Elena

doi:10.1007/s11605-021-04956-9

Cited by 15 publications

(13 citation statements)

References 38 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…These factors, in addition to the male sex, incorporate part of difficult cholecystectomy predictive scoring systems [10,11]. Furthermore, a CCI of over 6 was one factor associated with increased postoperative complications [12]. When correlated with ASA grade, this in part underlines the rationale behind the clinical decision-making with respect to radiological versus potential surgical management.…”

Section: Discussionmentioning

confidence: 99%

“…Coupled with the interventional procedure of cholecystostomy, the resultant fibrosis can make subsequent surgery more difficult. Indeed, the previous cholecystostomy is associated with increased postoperative morbidity [12]. Moreover, the one surgical complication observed was small bowel perforation, with dense intraoperative adhesions noted -a likely contributing factor.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Percutaneous Cholecystostomy for Acute Cholecystitis: A Three-Year Single-Centre Experience Including During COVID-19

Shakir¹,

Matwala²,

Vasan³

et al. 2021

Cureus

View full text Add to dashboard Cite

IntroductionPercutaneous cholecystostomy is a recognised treatment modality for acute cholecystitis. Traditionally, its use was reserved for patients deemed unfit for surgery. However, the coronavirus disease 2019 (COVID-19) pandemic had a detrimental effect on both elective and emergency surgery. The utilisation of cholecystostomy thus increased. Unanswered questions remain over timing with respect to interval cholecystectomy. We evaluated our local practice over the preceding three years. MethodsA retrospective analysis was performed of all patients who had a percutaneous cholecystostomy inserted over a three-year period (1 January 2018-1 January 2021). The primary outcome was time to cholecystectomy. Secondary outcomes were cholecystostomy-related complications, 30-day mortality, cholecystectomy-related complications and length of postoperative hospital stay. ResultsA total of 31 patients were identified during the period. Thirteen (42%) patients went on to have a laparoscopic cholecystectomy. The median time interval from cholecystostomy to cholecystectomy was 97 days (interquartile range [IQR]: 81-140, minimum: 47 and maximum: 791). One case was complicated by small bowel perforation; this occurred after an interval of 106 days. The median length of postoperative stay was one day (IQR: 1-1, minimum: 0 and maximum: 4). Cholecystostomy-related complications were observed in four (13%) patients, whereby three became displaced and one developed blockage. Thirty-day mortality following cholecystostomy insertion was zero. ConclusionsPercutaneous cholecystostomy is a safe and effective intervention for the management of acute cholecystitis. Interval cholecystectomy should be carefully considered; it may be safer to perform prior to 90 days.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Percutaneous Cholecystostomy for Acute Cholecystitis: A Three-Year Single-Centre Experience Including During COVID-19

Shakir¹,

Matwala²,

Vasan³

et al. 2021

Cureus

View full text Add to dashboard Cite

show abstract

“…14 The Chole-Risk score incorporated four variables (history of abdominal intervention, comorbidities, concomitant bile duct disease, and predictors of difficult cholecystectomy) in predicting complications with CD grade ≥ III. 12 The ACS-NSQIP surgical risk calculator predicts mortality and morbidity risks from 21 preoperative variables and was designed for universal use in various surgical fields. 21 Although these scores have been shown to predict morbidity risks with fair accuracy in early cholecystectomy of AC patients, the incorporation of numerous variables including specific comorbidities makes them convoluted for prompt use.…”

Section: Discussionmentioning

confidence: 99%

Simplified risk stratification in early cholecystectomy for acute cholecystitis based on age: A report from an institution with zero mortality

Matsui,

Yao,

Ishikawa

et al. 2023

J Hepato Biliary Pancreat

View full text Add to dashboard Cite

Background/PurposeThe existing risk stratification for early cholecystectomy in patients with acute cholecystitis (AC) is complex. This study aims to establish a simpler risk assessment for surgical complications after cholecystectomy based on age group.MethodsThis single‐center retrospective observational study enrolled 350 patients diagnosed with AC who underwent early cholecystectomy within 72 h of diagnosis from 2013 to 2021. Patients were divided into three subgroups based on age: young (<65 years), elderly (65–79 years), and very elderly (≥80 years). Since no mortality was observed, risk factors for the Clavien‐Dindo (CD) grade ≥ II complications were identified within the entire cohort and in each subgroup.ResultsThere were 120 young, 130 elderly, and 100 very elderly patients. The overall prevalence of complications with CD grade ≥ II was 11.1%. Age and Tokyo Guidelines 18 (TG18) severity were independent risk factors for surgical complications in the whole cohort. Subgroup analysis revealed that there was no independent risk factor in the young group. Meanwhile, age and poor physical status were independent risk factors in the elderly group, and TG18 severity in the very elderly group.ConclusionEvaluation of only age, physical status, and TG18 severity may be sufficient for risk stratification of surgical complications of AC.

show abstract

“…These grading scales range from simple to complex however most include both anatomic, physiologic and comorbidity variables. 8,9,18 The advantage of the AAST grade is its predictive capacity while relying on only minimal physiologic criteria and no comorbidity data. It also uses only objective data points that can be easily abstracted from an electronic record with respect to the clinical and imaging domains.…”

Section: Discussionmentioning

confidence: 99%

“…Many of the grading systems, including the original and revised AAST grade, have demonstrated good capacity for predicting outcomes. These grading scales range from simple to complex however most include both anatomic, physiologic and comorbidity variables 8,9,18 . The advantage of the AAST grade is its predictive capacity while relying on only minimal physiologic criteria and no comorbidity data.…”

Section: Discussionmentioning

confidence: 99%

Revision of the AAST grading scale for acute cholecystitis with comparison to physiologic measures of severity

Schuster

O’Connor

Cripps

et al. 2021

J Trauma Acute Care Surg

View full text Add to dashboard Cite

show abstract

How to Predict Postoperative Complications After Early Laparoscopic Cholecystectomy for Acute Cholecystitis: the Chole-Risk Score

Cited by 15 publications

References 38 publications

Percutaneous Cholecystostomy for Acute Cholecystitis: A Three-Year Single-Centre Experience Including During COVID-19

Percutaneous Cholecystostomy for Acute Cholecystitis: A Three-Year Single-Centre Experience Including During COVID-19

Simplified risk stratification in early cholecystectomy for acute cholecystitis based on age: A report from an institution with zero mortality

Revision of the AAST grading scale for acute cholecystitis with comparison to physiologic measures of severity

Contact Info

Product

Resources

About