Significance and clinical applications of ultrasound score in assessing the clinical severity of acute cholecystitis in the elderly

Zhang, Longfang; Han, Qi; Zhang, Hui; Li, Dongli; Yao, Kaihu

doi:10.1007/s40520-014-0236-9

Cited by 5 publications

(3 citation statements)

References 18 publications

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“…Studies reporting quantitative data on the role of the imaging in the diagnosis of acute cholecystitis in the elderly patient are limited to abdominal ultrasound. A study has reported that only half of patients with acute cholecystitis had conventional ultrasound (US) signs of acute cholecystitis including gallbladder distension, wall thickening, double-layer shadow, echo in gallbladder fluid, and peri-gallbladder effusion [23]. This indicates the poor sensitivity of the ultrasound.…”

Section: Resultsmentioning

confidence: 99%

2017 WSES and SICG guidelines on acute calcolous cholecystitis in elderly population

et al. 2019

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Background Gallstone disease is very common afflicting 20 million people in the USA. In Europe, the overall incidence of gallstone disease is 18.8% in women and 9.5% in men. The frequency of gallstones related disease increases by age. The elderly population is increasing worldwide. Aim The present guidelines aims to report the results of the World Society of Emergency Surgery (WSES) and Italian Surgical Society for Elderly (SICG) consensus conference on acute calcolous cholecystitis (ACC) focused on elderly population. Material and methods The 2016 WSES guidelines on ACC were used as baseline; six questions have been used to investigate the particularities in elderly population; the answers have been developed in terms of differences compared to the general population and to statements of the 2016 WSES Guidelines. The Consensus Conference discusses, voted, and modified the statements. International experts contributed in the elaboration of final statements and evaluation of the level of scientific evidences. Results The quality of the studies available decreases when we approach ACC in elderly. Same admission laparoscopic cholecystectomy should be suggested for elderly people with ACC; frailty scores as well as clinical and surgical risk scores could be adopted but no general consensus exist. The role of cholecystostomy is uncertain. Discussion and conclusions The evaluation of pro and cons for surgery or for alternative treatments in elderly suffering of ACC is more complex than in young people; also, the oldest old age is not a contraindication for surgery; however, a larger use of frailty and surgical risk scores could contribute to reach the best clinical judgment by the surgeon. The present guidelines offer the opportunity to share with the scientific community a baseline for future researches and discussion.

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Section: Resultsmentioning

confidence: 99%

2017 WSES and SICG guidelines on acute calcolous cholecystitis in elderly population

et al. 2019

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“…Some patients who are elderly and/or have dementia or paralysis are unlikely to present with local signs of inflammation (A) or systemic signs of inflammation (B) [ 21 ] because of their decreased antistress capacity, especially the elderly [ 22 , 23 ]. In the elderly with AC, the significance of ultrasound examination prior to cholecystectomy is emphasized because ultrasound score can accurately determine AC severity and may be used as a reference for surgical intervention timing and mode selection to guide clinical therapy [ 24 ]. Therefore, we recommend reassessment of the TG13 diagnostic criteria by taking the elderly and/or those with dementia into consideration.…”

Section: Discussionmentioning

confidence: 99%

“…Fever and elevated white blood cell count are not usually observed in elderly patients with AC because of their decreased antistress capacity [ 22 , 23 ]. Recently, Zhang et al [ 24 ] reported the significance of ultrasound examination in the elderly with AC because ultrasound score could accurately determine AC severity in the elderly. Therefore, the TG13 diagnostic criteria should be reassessed, especially in the elderly.…”

Section: Introductionmentioning

confidence: 99%

Factor Analysis Influencing Postoperative Hospital Stay and Medical Costs for Patients with Definite, Suspected, or Unmatched Diagnosis of Acute Cholecystitis according to the Tokyo Guidelines 2013

Hayasaki

Takahashi

Fujii

et al. 2016

Gastroenterology Research and Practice

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Purpose. To identify significant independent preoperative factors influencing postoperative hospital stay (PHS) and medical costs (MC) in 171 patients who underwent cholecystectomy for benign gallbladder diseases and had definite, suspected, or unmatched acute cholecystitis (AC) diagnosis according to the Tokyo Guidelines 2013 (TG13). Methods. The 171 patients were classified according to the combination of diagnostic criteria including local signs of inflammation (A), systemic signs of inflammation (B), and imaging findings (C): A+ B+ C (definite diagnosis, n = 84), A+ B (suspected diagnosis, n = 25), (A or B) + C (n = 10), A (n = 41), and B (n = 11). Results. The A+ B + C and (A or B) + C groups had equivalent PHS and MC, suggesting that imaging findings were essential for AC diagnosis. PHS and MC were significantly increased in the order of severity grades based on TG13. Performance status (PS), white blood cell count, and severity grade were identified as preoperative factors influencing PHS by multivariate analysis, and significant independent preoperative factors influencing MC were age, PS, preoperative biliary drainage, hospital stay before surgery, albumin, and severity grade. Conclusion. PS and severity grade significantly influenced prolonged PHS and increased MC.

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Benign Disease of the Gallbladder and Pancreas in the Elderly

Cox¹,

Perez²

2017

Principles and Practice of Geriatric Surgery

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Significance and clinical applications of ultrasound score in assessing the clinical severity of acute cholecystitis in the elderly

Abstract: Prior to cholecystectomy, ultrasound score could accurately determine the severity of acute cholecystitis in the elderly and may be used as a reference for surgical intervention timing and mode selection to guide clinical therapy.

Cited by 5 publications

References 18 publications

2017 WSES and SICG guidelines on acute calcolous cholecystitis in elderly population

2017 WSES and SICG guidelines on acute calcolous cholecystitis in elderly population

Factor Analysis Influencing Postoperative Hospital Stay and Medical Costs for Patients with Definite, Suspected, or Unmatched Diagnosis of Acute Cholecystitis according to the Tokyo Guidelines 2013

Benign Disease of the Gallbladder and Pancreas in the Elderly

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