Surgical management of acute cholecystitis

Koti, Rahul; Davidson, Christopher J.; Davidson, Brian R

doi:10.1007/s00423-015-1306-y

Cited by 34 publications

(26 citation statements)

References 87 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In cases of acute complications, gallbladder tissue or bile for culture are not available and management options agree on supportive care and early antibiotic use, but delayed cholecystectomy and percutaneous drainage cholecystostomy remain controversial [43][44][45][46].…”

Section: Discussionmentioning

confidence: 99%

Gallbladder microbiota variability in Colombian gallstones patients

Arteta¹,

Carvajal-Restrepo²,

Sánchez-Jiménez³

et al. 2017

J Infect Dev Ctries

View full text Add to dashboard Cite

Introduction: Gallbladder stones are a very frequently occurring condition. Despite bile bactericidal activity, many bacteria have been detected inside the gallbladder, and gallstones facilitate their presence. Between 3% and 5% of the patients with Salmonella spp. infection develop the carrier stage, with the bacteria persisting inside the gallbladder, shedding bacteria in their feces without signs of infection. The aim of this study was to isolate bacteria from Colombian patients with gallstones, using standard culturing methods, and to identify Salmonella spp. carriers by molecular techniques. Methodology: A total of 149 patients (120 female and 29 male) diagnosed with gallstones who underwent cholecystectomy and who did not have symptoms of acute inflammation were included. Gallbladder tissue and bile were cultured and used for DNA extraction and Salmonella spp. hilA gene detection. Results: Of the 149 patients 28 (19%) had positive cultures. Twenty-one (75%) patients with positive cultures were from Medellin's metropolitan area. In this geographical location, the most frequent isolations were Pseudomonas spp. (38%), Klebsiella spp. (23%), and Proteus spp. (9%) in addition to unique cases of other bacteria. In Apartado, the isolates found were Enterobacter cloacae (50%), Raoultella terrigena (32%), and both Enterobacter cloacae and Raoultella terrigena were isolated in one (18%) male patient. Five (3.3%) of the 149 patients had positive polymerase chain reaction (PCR) results for the hilA gene of Salmonella spp., all of whom were female and residents of the Medellín metropolitan area. Conclusions: The gallbladder microbiota variability found could be related to geographical, ethnic, and environmental conditions.

show abstract

Section: Discussionmentioning

confidence: 99%

Gallbladder microbiota variability in Colombian gallstones patients

Arteta¹,

Carvajal-Restrepo²,

Sánchez-Jiménez³

et al. 2017

J Infect Dev Ctries

View full text Add to dashboard Cite

show abstract

“…Odvzete kužnine pošljemo na mikrobiološko preiskavo, tako da lahko po operaciji uvedemo usmerjeno antibiotično zdravljenje glede na antibiogram. Pri abscesu ob žolčniku, perforaciji žolčnika, emfizematskem ali gangrenskem holecistitisu se po japonskih smernicah priporoča podaljša-no antibiotično zdravljenje 4 do 5 dni po operaciji oziroma usmerjeno antibiotič-no zdravljenje glede na izvid antibiograma vsaj 14 dni pri dokazani bakteriemiji s po Gramu pozitivnimi bakterijami (1).…”

Section: Konzervativno Zdravljenjeunclassified

“…Po opravljenih 30 laparoskopskih holecistektomijah naj bi kirurg uspešno opravil učno krivuljo, ker naj bi se 75 % zapletov pri vseh kirurgih pojavljalo le znotraj učne krivulje (27). Tudi po opravljeni učni krivulji niso vsi kirurgi enako vešči laparoskopske holecistektomije v težjih razmerah, zato se priporoča, da operacijo pri akutnem holecistitisu izvede kirurg z največ izkušnjami na področju laparoskopske in hepatobiliarne kirurgije (1).…”

Section: Izsledki Kliničnih šTudij In Metaanalizunclassified

Akutno vnetje žolčnika – zgodnja operacija ali poskus konzervativnega zdravljenja?

Janež¹

2018

SlovMedJour

View full text Add to dashboard Cite

IzvlečekAkutno vnetje žolčnika oziroma akutni holecistitis je pogosta bolezen, ki večkrat zahteva sprejem v bolnišnico in kirurško zdravljenje. Najpogosteje se pojavlja pri ljudeh, ki imajo žolčne kamne, pojavi pa se lahko tudi v odsotnosti žolčnih kamnov. Diagnozo akutnega holecistitisa postavimo na osnovi klinične slike, laboratorijskih izvidov in ultrazvoka trebuha. Algoritmi za bolnike, ki imajo akutno vnetje žolčnika brez pridruženih bolezni, so znani; odločitev za kirurški poseg pri bolnikih s pridruženimi boleznimi pa je odvisna od več dejavnikov. Laparoskopska holecistektomija je metoda izbire zdravljenja bolnikov z akutnim holecistitisom. Rezultati zdravljenja so bistveno boljši, kadar kirurški poseg napravimo znotraj 72 ur od nastopa kliničnih znakov.V prispevku so predstavljena najnovejša priporočila za obravnavo bolnikov z akutnim holecistitisom, povzeta po smernicah iz Tokia ter smernicah Svetovnega združenja za urgentno kirurgijo iz leta 2016 ter na koncu še izsledki in izkušnje nekaterih kliničnih študij in metaanaliz. AbstractAcute cholecystitis is a common disease, which often requires admission to hospital and surgical treatment. Acute cholecystitis is defined as inflammation of the gallbladder and usually occurs due to cystic duct obstruction from stones or sludge. It is a relatively common complication of gallstones, but it can also occur without gallstones. A combination of relevant clinical symptoms and ultrasound evidence is required to make a diagnosis of acute cholecystitis. Early surgery is recommended for all patients that are in good physical condition. There is still a debate how to treat high-risk and critically ill patients. Laparoscopic cholecystectomy is the method of choice for treatment of patients with acute cholecystitis. Early laparoscopic cholecystectomy should be done within 72 hours from the onset of symptoms. This article presents current guidelines according to the Tokyo guidelines and the World Society of Emergency Surgery guidelines, and at the end, experiences of some clinical trials. UvodAkutno vnetje žolčnika oziroma akutni holecistitis je pogosto bolezen, ki velikokrat zahteva bolnišnično zdravljenje in operacijo. Najpogosteje se pojavlja pri ljudeh z žolčnimi kamni, lahko pa tudi brez njih (1). Vnetje žolčnika brez prisotnosti kamnov je pogostejše pri kritično bolnih, ki so dlje časa na parenteralni prehrani, pri politravmatiziranih bolnikih, pri večjih opeklinah in pri bolnikih po srčnih operacijah (2). Akutni holecistitis je še posebej pogost vzrok

show abstract

“…In particular, acute cholecystitis can be treated with robotic-assisted approach showing postoperative overlapping outcomes with symptomatic gallstones disease [64]. On the contrary, the data from a study based on the literature search with randomized controlled trials and population-based analyses shows that the advantages of current use of robotic surgery in cholecystectomy are not provable [65].…”

Section: Updates In Gallbladder Diseasesmentioning

confidence: 99%

Acute Cholecystitis: Diagnostic Pitfall and Timing of Treatment

Cianci¹,

Tartaglia²,

Fersini³

et al. 2017

Updates in Gallbladder Diseases

View full text Add to dashboard Cite

Objective: Cholelithiasis represents a very frequent health problem with higher prevalence in developed countries. The aim of this chapter is to underline, also by submitting our surgical experience, some diagnostic deceptions and the timing of treatment. Methods:The presentation of 42 patients admitted in our institution (September 2012/ September 2014) with the diagnosis of acute pancreatitis allows to identify two different clinical forms of acute biliary pancreatitis: the pancreatic pattern and biliary pattern. Moreover, the evaluation of another 42 patients observed in our institution (September 2014/September 2016) with acute cholecystitis should show our treatment program. Also, we added the analysis of our previous research, regarding acute cholecystitis, already published: difficult cholecystectomy, antegrade dissection in laparoscopic cholecystectomy, postoperative morbidity, laparoscopic approach in cirrhotics, finally the robotic experience.Results: Clinical features, laboratory, and imaging exams should identify, into acute biliary pancreatitis, two clinical forms as biliary pattern and pancreatic pattern for different therapeutic approach. The treatment chosen for acute cholecystitis is early laparoscopic cholecystectomy within 24-72 hours. Severe, complicated acute cholecystitis can require urgent surgical intervention. Conclusion:Acute cholecystitis encompasses clinical forms with various degree of severity and several clinical courses. The treatment is focused on early cholecystectomy with various and different management strategies, suitable to the specific pathological conditions.

show abstract

Surgical management of acute cholecystitis

Abstract: Trial evidence would favour a policy of early laparoscopic cholecystectomy following admission with acute cholecystitis. The optimal approach to support early cholecystectomy is suggested but requires evidence from further randomised trials.

Cited by 34 publications

References 87 publications

Gallbladder microbiota variability in Colombian gallstones patients

Gallbladder microbiota variability in Colombian gallstones patients

Akutno vnetje žolčnika – zgodnja operacija ali poskus konzervativnega zdravljenja?

Acute Cholecystitis: Diagnostic Pitfall and Timing of Treatment

Contact Info

Product

Resources

About