Laparoscopic cholecystectomy for acute cholecystitis: is the surgery still safe beyond the 7-day barrier? A multicentric observational study

Martino, Marcello Di; Mora-Guzmán, Ismael; Jodra, Víctor Vaello; Dehesa, A. Sanjuanbenito; Morales-García, Dieter; Ruíz, R.; Nisa, Francisca García‐Moreno; Mendoza‐Moreno, Fernando; 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; Martín-Pérez, Elena

doi:10.1007/s13304-020-00924-1

Cited by 7 publications

(5 citation statements)

References 34 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Although the Tokyo guidelines clearly state the clinical and statistical advantages of an early cholecystectomy against conservative treatment and the subsequent risk of recurrent symptoms while waiting for an elective LC, some authors voice arguable concerns about the risk of increased complications and suboptimal treatments in the acute setting [ 29 ]. Also for this reason, some author suggests prudence in approaching with a LC patients whose symptoms of acute cholecystitis last for more than a week [ 30 ], echoing the old-fashioned and not fully demonstrated adage that an acute cholecystitis should be operated within 12 hours from the beginning of the symptoms or after 12 weeks. In our experience, we have not been able to demonstrate any association between increased surgical morbidity or risk of suboptimal treatment and timing of surgery in patients operated during the index emergency admission.…”

Section: Discussionmentioning

confidence: 99%

Prognostic factors and predictive models in hot gallbladder surgery: A prospective observational study in a high-volume center

Tebala,

Shabana,

Patel

et al. 2024

Ann Hepatobiliary Pancreat Surg

View full text Add to dashboard Cite

Backgrounds/Aims The standard treatment for acute cholecystitis, biliary pancreatitis and intractable biliary colics (“hot gallbladder”) is emergency laparoscopic cholecystectomy (LC). This paper aims to identify the prognostic factors and create statistical models to predict the outcomes of emergency LC for “hot gallbladder.” Methods A prospective observational cohort study was conducted on 466 patients having an emergency LC in 17 months. Primary endpoint was “suboptimal treatment,” defined as the use of escape strategies due to the impossibility to complete the LC. Secondary endpoints were postoperative morbidity and length of postoperative stay. Results About 10% of patients had a “suboptimal treatment” predicted by age and low albumin. Postop morbidity was 17.2%, predicted by age, admission day, and male sex. Postoperative length of stay was correlated to age, low albumin, and delayed surgery. Conclusions Several predictive prognostic factors were found to be related to poor emergency LC outcomes. These can be useful in the decision-making process and to inform patients of risks and benefits of an emergency vs. delayed LC for hot gallbladder.

show abstract

Section: Discussionmentioning

confidence: 99%

Prognostic factors and predictive models in hot gallbladder surgery: A prospective observational study in a high-volume center

Tebala,

Shabana,

Patel

et al. 2024

Ann Hepatobiliary Pancreat Surg

View full text Add to dashboard Cite

show abstract

“…In the literature, several studies support performing ELC without considering symptom duration [7,12,[17][18][19][20]. However, studies still support the 72-hour rule or limiting the symptom duration to seven days [6,21,22].…”

Section: Discussionmentioning

confidence: 99%

“…Most of these studies lack subgroup analysis, with only two out of the mentioned nine studies performing such analysis. Dimartino et al [12] conducted a study where higher conversion rates to open cholecystectomy and intraoperative complications were observed after seven days from symptom onset. However, when hospitals were categorized into high-and low-volume centers based on their early laparoscopic case volumes in one year, the adverse outcomes after seven days were seen primarily in lowvolume centers, while no significant difference was observed in high-volume centers.…”

Section: Discussionmentioning

confidence: 99%

“…However, limited research is available that evaluates surgeon experience or the relationship between surgeon experience and symptom duration in ELC [12][13][14][15]. Surgeon experience plays a crucial role in determining outcomes in laparoscopic surgery.…”

Section: Introductionmentioning

confidence: 99%

“…These three studies aimed to compare surgeons who received training in laparoscopic surgery with those who did not receive such training. In the study conducted by Di Martino et al [12], all surgeons included in the study had received training in laparoscopic surgery. The findings revealed that complication rates were similar between patients with symptom duration within the first seven days and those with symptom duration beyond seven days.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Symptom Duration and Surgeon Volume: Impact on Early Laparoscopic Cholecystectomy for Acute Cholecystitis

Güneş,

Taşdelen,

Ergin

et al. 2023

Cureus

View full text Add to dashboard Cite

Background: The 'golden 72 hours' rule from the onset of symptoms still applies in laparoscopic cholecystectomy for acute cholecystitis. This rule has been discussed with increasing experience in laparoscopic surgery in recent years.Objective: This study aims to determine the optimal symptom duration based on the surgeon's volume when deciding on early laparoscopic cholecystectomy for acute cholecystitis.Materials and Methods: The patients were categorized into two groups: Group 1 (≤3 days) and Group 2 (>3 days) based on the symptom duration, and high-volume surgeons (performing >100 laparoscopic cholecystectomies in a year) and low-volume surgeons (performing <100 laparoscopic cholecystectomies in a year) based on the surgeon volume. All surgeons had received advanced training in laparoscopic surgery.Results: There was no statistical difference in postoperative outcomes between groups, except for a few data (p>0.05). The operative time was longer in Group 2, the postoperative hospital stay was longer for lowvolume surgeons than for high-volume surgeons after three days, and operative time was longer after three days than the first three days in low-volume surgeons (p<0.05).Conclusions: Early laparoscopic cholecystectomy may be recommended for acute cholecystitis with symptom duration of more than three days, regardless of the surgeon volume, as long as they are competent in laparoscopic surgeries.

show abstract

Early laparoscopic cholecystectomy for acute cholecystitis: should we operate beyond the first week?

Barka

Jarrar

Sahli

et al. 2023

Langenbecks Arch Surg

View full text Add to dashboard Cite

Laparoscopic cholecystectomy for acute cholecystitis: is the surgery still safe beyond the 7-day barrier? A multicentric observational study

Cited by 7 publications

References 34 publications

Prognostic factors and predictive models in hot gallbladder surgery: A prospective observational study in a high-volume center

Prognostic factors and predictive models in hot gallbladder surgery: A prospective observational study in a high-volume center

Symptom Duration and Surgeon Volume: Impact on Early Laparoscopic Cholecystectomy for Acute Cholecystitis

Early laparoscopic cholecystectomy for acute cholecystitis: should we operate beyond the first week?

Contact Info

Product

Resources

About