Sex-based analysis of the outcome of laparoscopic cholecystectomy for acute cholecystitis

Lee, H. K.; Han, Ho Seong; Min, Seog Ki; Lee, J.-H.

doi:10.1002/bjs.4870

Cited by 45 publications

(43 citation statements)

References 18 publications

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“…24,25 The rate of conversion will affect operative times, postoperative morbidity and hospital costs with Tang and Cuschieri in a systematic review, showing older age, morbid obesity, cirrhosis, prior upper abdominal surgery and the need for emergent surgery to all increase the conversion risk. 26 Others have reported the same finding as in our study, namely that male gender was also associated with a higher conversion risk 7,[27][28][29] where this effect is most probably linked to a more frequent incidence of severe acute and chronic disease in men. In our series, spilled stones were more common in the delayed cholecystectomy groups (2 and 3) and were recorded less frequently in those undergoing an emergent LC.…”

Section: Discussionsupporting

confidence: 86%

Acute cholecystitis managed in a rural surgical department

Kopelman¹,

Abaya²,

Kaplan³

et al. 2018

AMJ

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Section: Discussionsupporting

confidence: 86%

Acute cholecystitis managed in a rural surgical department

Kopelman¹,

Abaya²,

Kaplan³

et al. 2018

AMJ

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“…Five and a half million people in the UK (9% of the population) have gallstones [1]. Although two thirds of gallstones are asymptomatic, they may cause acute or chronic cholecystitis, biliary colic, pancreatitis, or obstructive jaundice.…”

mentioning

confidence: 99%

“…Although two thirds of gallstones are asymptomatic, they may cause acute or chronic cholecystitis, biliary colic, pancreatitis, or obstructive jaundice. Acute cholecystitis is a severe form of symptomatic cholelithiasis, and 10%-30% of patients with acute disease develop life-threatening complications such as empyema, gangrene, or perforation [1].…”

mentioning

confidence: 99%

Delay from Symptom Onset Increases the Conversion Rate in Laparoscopic Cholecystectomy for Acute Cholecystitis

et al. 2007

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Background Randomized trials suggest that laparoscopic cholecystectomy should be performed on first admission for acute cholecystitis. However, this is not widely practiced, possibly because of a perceived high conversion rate. We hypothesized that delay from onset of symptoms may increase the conversion rate. Methods We performed a retrospective case note review of patients undergoing emergency cholecystectomy in a single institution between January 2002 and December 2005. We analyzed whether delay from onset of symptoms was related to the conversion rate in patients with a histopathological diagnosis of acute cholecystitis. Results Of patients who underwent emergency laparoscopic cholecystectomy in our institution, 32.4% (197/608) had acute cholecystitis on histopathology. The conversion rate of those with acute cholecystitis was considerably higher (24.4%) than for those with other pathologies (6.3%). For patients with acute cholecystitis, the conversion rates increased with duration of symptoms: 9.5%, 16.1%, 38.9%, and 38.6% for delays of 0-2 days, 3-4 days, 5-6 days, and > 6 days from symptom onset, respectively (chi-square for trend = 14.27, DF = 1, p = 0.00016). Most conversions were due to the presence of acute inflammatory adhesions. Conclusions Early intervention for acute cholecystitis (preferably within 2 days of onset of symptoms) is most likely to result in successful laparoscopic cholecystectomy; increasing delay is associated with conversion to open surgery.The abstract was presented at

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“…El sexo masculino fue un factor de riesgo para la conversión, lo cual concuerda con otros estudios 7,[14][15][16]18,19,21 . En el contexto de colelitiasis sintomática, los hombres presentan más inflamación y fibrosis que las mujeres con la misma patología 22 .…”

Section: Discussionunclassified

Factores de riesgo preoperatorios asociados a conversión a técnica abierta en colecistectomía laparoscópica de urgencia

Chinchilla¹,

Baquero

J³

2018

rev. colomb. cir.

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Citar como: Chinchilla PA, Baquero DR, Ruiz JE. Factores preoperatorios de riesgo asociados a conversión a técnica abierta en colecistectomía laparoscópica de urgencia. Rev Colomb Cir. 2018;33:145-56 ResumenIntroducción. La colecistectomía laparoscópica es la técnica de elección en pacientes con indicación de extracción quirúrgica de la vesícula; sin embargo, en promedio, el 20 % de estos requieren conversión a técnica abierta. En este estudio se evaluaron los factores preoperatorios de riesgo para conversión en colecistectomía laparoscópica de urgencia.Metodología. Se llevó un estudio de casos y controles no pareado. Se obtuvo información sociodemográfica y de las variables de interés de los registros de las historias clínicas de los pacientes operados entre el 2013 y el 2016. Se identificaron los motivos de conversión de la técnica quirúrgica. Se caracterizó la población de estudio y se estimaron las asociaciones según la naturaleza de las variables. Mediante un análisis de regresión logística se ajustaron las posibles variables de confusión.Resultados. Se analizaron los datos de 444 pacientes (111 casos y 333 controles). La causa de conversión más frecuente fue la dificultad técnica (50,5 %). Se encontró que la mayor edad, el sexo masculino, el antecedente de cirugía abierta en hemiabdomen superior, el signo clínico de Murphy positivo, la dilatación de la vía biliar, la leucocitosis y la mayor experiencia del cirujano fueron los factores de riesgo para la conversión. Se encontró un área bajo la curva ROC de 0,743 (IC 95% 0,692-0,794, p≤0,001).Discusión. Existen factores que se asocian a mayor riesgo de conversión en colecistectomía laparoscópica. La mayoría se relaciona con un proceso inflamatorio avanzado, por lo que la intervención temprana y oportuna debe ser el estándar de manejo en el abordaje de pacientes con patología quirúrgica de la vesícula.Palabras clave: colelitiasis; colecistectomía laparoscópica; conversión a cirugía abierta; factores de riesgo; medición de riesgo. 146Chinchilla PA, Baquero DR, Ruiz JE Rev Colomb Cir. 2018;33:145-53

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Sex-based analysis of the outcome of laparoscopic cholecystectomy for acute cholecystitis

Abstract: Male sex was identified as a risk factor for more severe acute cholecystitis, but outcome for men after laparoscopic cholecystectomy was not significantly different from that for women.

Cited by 45 publications

References 18 publications

Acute cholecystitis managed in a rural surgical department

Acute cholecystitis managed in a rural surgical department

Delay from Symptom Onset Increases the Conversion Rate in Laparoscopic Cholecystectomy for Acute Cholecystitis

Factores de riesgo preoperatorios asociados a conversión a técnica abierta en colecistectomía laparoscópica de urgencia

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