Laparoscopic management of acute cholecystitis

Zucker, Karl A.; Flowers, John L.; Bailey, Robert W.; Graham, Scott M.; Buell, Joseph; Imbembo, Anthony L.

doi:10.1016/s0002-9610(05)80951-1

Cited by 120 publications

(86 citation statements)

References 11 publications

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“…3,4 Although LC is performed routinely as an emergent treatment option of AC, postoperative complications are still of major concern. Morbidity rates after LC in elderly patients with high surgical risk are reported to be between 14% and 46%.…”

Section: Introductionmentioning

confidence: 99%

Timing of Cholecystectomy after Percutaneous Cholecystostomy for Acute Cholecystitis

Jung

Park

2015

Korean J Gastroenterol

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Background/Aims: Laparoscopic cholecystectomy is the standard treatment for acute cholecystitis. Percutaneous cholecystostomy is an alternative treatment to resolve acute inflammation in patients with severe comorbidities. The purpose of this study is to determine the optimal timing of laparoscopic cholecystectomy after percutaneous cholecystostomy for the patients with acute cholecystitis. Methods: This retrospective study was conducted in patients who underwent cholecystectomy after percutaneous cholecystostomy from January 2010 through November 2014. Seventy-four patients were included in this study. The patients were divided into two groups by the operation timing. Group I patients underwent cholecystectomy within 10 days after percutaneous cholecystostomy (n=30) and group II patients underwent cholecystectomy at more than 10 days after percutaneous cholecystostomy (n=44). Results: There was no significant difference between groups in conversion rate to open surgery, operation time, perioperative complications rate, and days of hospital stay after operation. However, complications related to cholecystostomy such as catheter dislodgement occurred significantly more often in group II than group I (group I:group II=0%:18.2%; p=0.013). Conclusions: Timing of laparoscopic cholecystectomy after percutaneous cholecystostomy did not influence postoperative outcomes. However, late surgery caused more complications related to cholecystostomy than early surgery. Therefore, early laparoscopic cholecystectomy should be considered over late surgery after percutaneous cholecystostomy insertion. (Korean J Gastroenterol 2015;66:209-214)

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Section: Introductionmentioning

confidence: 99%

Timing of Cholecystectomy after Percutaneous Cholecystostomy for Acute Cholecystitis

Jung

Park

2015

Korean J Gastroenterol

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“…8,13 Also, there was no significant difference in any of the parameters compared between laparoscopic cholecystectomy performed within 48 h to within seven days of acute cholecystitis and surgery performed after 6 weeks of the attack of acute cholecystitis. 1,[8][9][10][11][12][13][14][15][16] The longer duration of surgery for group 1 compared to group 2 could be attributed to the significantly higher percentage of pus-filled gallbladder, gangrenous gall bladder encountered during surgery, and the time taken for endobag retrieval and drain placement, though it was comparable in both groups.…”

Section: Discussionmentioning

confidence: 99%

“…Performing this procedure during the phase of acute inflammation are associated, even in expert hands, with a high incidence of conversion to open surgery. [11][12][13][14] resulting in the loss of the advantages of this minimally invasive procedure. However, recently laparoscopic cholecystectomy is considered to be the standard of care if the patient is seen within 48 h of the attack of acute cholecystitis because adhesions would not have developed so early after the onset of inflammation.…”

Section: 2mentioning

confidence: 99%

A study to evaluate the optimal time for laparoscopic cholecystectomy after acute cholecystitis attack: a tertiary care centre study

Chauhan

Charpot

2016

Int Surg J

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Background: Initially, laparoscopic cholecystectomy was contraindicated in patients with acute cholecystitis because of the fear of increased morbidity and high rates (60%) of conversion to open surgery. Nowadays, acute cholecystitis is a common cause of acute abdominal pain and the definitive treatment is laparoscopic cholecystectomy but when to perform surgery still remains controversial. The purpose of this study is to find out whether laparoscopic cholecystectomy can be performed for acute cholecystitis irrespective of the time since onset of acute symptoms. Methods: A total of 100 laparoscopic cholecystectomies performed for acute cholecystitis were evaluated for duration of surgery, conversion rates, biliary and other organ injury, and postoperative stay by chi square test and paired t-tests using SPSS software. 45 patients underwent laparoscopic cholecystectomy within 48 h to seven days of onset of symptoms (group 1) and 55 patients underwent surgery after 6 weeks of onset of symptoms (group 2). Results: While the duration of surgery was comparable in both groups (56.5±15 vs. 45.5±15 min), there were no significant difference in conversions or major biliary or other organ injury in any of the two groups. Postoperative stay was also comparable between the two groups (4±1.5 vs 3±1.5, days) but total hospital stay was significantly reduced in group1 compared to group 2 (5±1.5 vs 8.5±1.5 days) and so as total cost is also reduced. Conclusions: Laparoscopic cholecystectomy can safely be performed at any time after the onset of acute cholecystitis. Early laparoscopic cholecystectomy has an outcome comparable to the delayed procedure, with a shorter total hospital stay and lower total costs, and it should be considered as the preferred approach in treatment of acute cholecystitis.

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“…However, study by Zucker et al dealing with 720 cases has reported no bile duct or major vascular injury 16 . In Hammazaki study, major complications were seen in 3 cases with bile duct injury (2% ) and bleeding encountered during operation and controlled easily under laparoscopy 17 .…”

Section: Paralytic Ileusmentioning

confidence: 98%

Role of Laproscopic Cholecystectomy in the Management of Acute Cholecystitis

2005

J Liaquat Uni Med Health Sci

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Laparoscopic management of acute cholecystitis

Cited by 120 publications

References 11 publications

Timing of Cholecystectomy after Percutaneous Cholecystostomy for Acute Cholecystitis

Timing of Cholecystectomy after Percutaneous Cholecystostomy for Acute Cholecystitis

A study to evaluate the optimal time for laparoscopic cholecystectomy after acute cholecystitis attack: a tertiary care centre study

Role of Laproscopic Cholecystectomy in the Management of Acute Cholecystitis

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