Systematic review and meta-analysis of early vs late interval laparoscopic cholecystectomy following percutaneous cholecystostomy

Kourounis, G; Rooke, Zoë Cáit; McGuigan, Mark; Georgiades, Fanourios

doi:10.1016/j.hpb.2022.03.016

Cited by 6 publications

(5 citation statements)

References 49 publications

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“…A systemic review and meta-analysis of early versus delayed laparoscopic cholecystectomy following percutaneous cholecystostomy in elderly patients was conducted by Kourounis et al 29 studies were included and there was no difference with regards to conversion rates, morbidity, and mortality between the groups. This study concluded that the timing of cholecystectomy after percutaneous cholecystostomy has no impact on the management of acute cholecystitis [37].…”

Section: Early Laparoscopic Cholecy-stectomy In Elderly Patientsmentioning

confidence: 84%

Laparoscopic Cholecystectomy in Acute Cholecystitis: An Updated Review

Rajah

2024

AJMAH

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Laparoscopic cholecystectomy is the gold standard for the management of gallstone disease, but it has recently been incorporated into the treatment of acute cholecystitis. It is divided into early and delayed laparoscopic cholecystectomy. Early laparoscopic cholecystectomy is done within 72 hours of the onset of symptoms, and delayed laparoscopic cholecystectomy is done after eight weeks. As there is no consensus on the timing of early laparoscopic cholecystectomy in adults and elderly patients, we have conducted this review article to examine the timing of early laparoscopic cholecystectomy, the risk factors for conversion to open cholecystectomy, and the role of laparoscopic subtotal cholecystectomy in the management of acute cholecystitis.

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Section: Early Laparoscopic Cholecy-stectomy In Elderly Patientsmentioning

confidence: 84%

Laparoscopic Cholecystectomy in Acute Cholecystitis: An Updated Review

Rajah

2024

AJMAH

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“…Previous percutaneous cholecystostomy also had a negative influence, although cholecystostomy has been widely used since the publication of the Tokyo Guidelines, numerous publications have noted its high associated morbidity, the difficulty of the laparoscopic approach, prolongation of hospital stay, and the high readmission rate. As a result, in spite of its value for managing acute episodes in fragile and high-risk patients, it should not be considered as innocuous, or as the gold standard treatment [ 38 – 46 ].…”

Section: Discussionmentioning

confidence: 99%

Textbook outcome in urgent early cholecystectomy for acute calculous cholecystitis: results post hoc of the S.P.Ri.M.A.C.C study

Fugazzola,

Carbonell-Morote,

Cobianchi

et al. 2024

World J Emerg Surg

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Introduction A textbook outcome patient is one in which the operative course passes uneventful, without complications, readmission or mortality. There is a lack of publications in terms of TO on acute cholecystitis. Objetive The objective of this study is to analyze the achievement of TO in patients with urgent early cholecystectomy (UEC) for Acute Cholecystitis. and to identify which factors are related to achieving TO. Materials and methods This is a post hoc study of the SPRiMACC study. It´s a prospective multicenter observational study run by WSES. The criteria to define TO in urgent early cholecystectomy (TOUEC) were no 30-day mortality, no 30-day postoperative complications, no readmission within 30 days, and hospital stay ≤ 7 days (75th percentile), and full laparoscopic surgery. Patients who met all these conditions were taken as presenting a TOUEC. Outcomes 1246 urgent early cholecystectomies for ACC were included. In all, 789 patients (63.3%) achieved all TOUEC parameters, while 457 (36.6%) failed to achieve one or more parameters and were considered non-TOUEC. The patients who achieved TOUEC were younger had significantly lower scores on all the risk scales analyzed. In the serological tests, TOUEC patients had lower values for in a lot of variables than non-TOUEC patients. The TOUEC group had lower rates of complicated cholecystitis. Considering operative time, a shorter duration was also associated with a higher probability of reaching TOUEC. Conclusion Knowledge of the factors that influence the TOUEC can allow us to improve our results in terms of textbook outcome.

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“…A retrospective study comparing 1211 patients with early cholecystectomy (0–8 weeks) versus late cholecystectomy (> 8 weeks) found that the early cholecystectomy group had a higher risk of complications and longer hospital stay [ 36 ]. In a meta-analysis published in 2022 Kourunis et al [ 37 ] compared the performance of cholecystectomy during the first 30 days and at a later date in 41 prospective and retrospective studies, without finding statistically significant differences in the clinical results. However, there was a slightly higher conversion rate in the cholecystectomy group after 30 days: 7.2% vs. 8.3%.…”

Section: Discussionmentioning

confidence: 99%

Impact of percutaneous cholecystostomy in the management of acute cholecystitis: a retrospective cohort study at a tertiary center

et al. 2023

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Laparoscopic cholecystectomy is the gold standard for the treatment of acute cholecystitis (AC). Percutaneous cholecystostomy (PC) for management of AC is increasing; safe and less invasive than laparoscopic cholecystectomy and is very useful in selected patients with severe comorbidities, not suitable for surgery/general anesthesia. We conducted a retrospective observational study between 2016 and 2021 of patients treated with PC for AC, based on the application of the Tokyo guidelines 13/18. The aim was to analyse the clinical results and management of PC in patients undergoing elective or emergency cholecystectomy. Subsequently, a retrospective analytical study was designed to compare various cohorts: elective or emergency surgery and management with PC alone; patients with/without a high surgical risk; and elective vs emergency surgery. Hundred and ninety five patients with AC were treated with PC. Mean age was 74 years, 59.5% were ASA class III/IV, and the mean Charlson comorbidity index was 5.5. Adherence to Tokyo guidelines regarding indication of PC was 50.8%. The rate of complications associated to PC was 12.3% and the 90-day mortality rate was 14.4%. Mean length of time using PC was 10.7 days. Emergency surgery was performed in 4.6%. The overall success rate using PC was 66.7%, and the 1-year readmission rate due to biliary complications after PC was 28.2%. The rate of scheduled cholecystectomy after PC was 22.6%. Conversion to laparotomy and open approach was more frequent in patients who underwent emergency surgery (p = 0.009). No differences were found in 90-day mortality or in the complication rate. PC achieves improvements in the inflammation and infection associated with AC. In our series, it proved to be an effective and safe treatment during the acute episode of AC. Mortality in patients treated with PC is high due to their older age, greater morbidity, and higher Charlson comorbidity index scores. After PC, emergency surgery is uncommon but readmission due to biliary events is high. Cholecystectomy after PC is the definitive treatment and the laparoscopic approach is feasible. Clinical trial registery: The study was registered in the public accessible database clinicaltrials.gov with the ClinicalTrials.gov ID: NCT05153031. Public release date: 12/09/2021.

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Systematic review and meta-analysis of early vs late interval laparoscopic cholecystectomy following percutaneous cholecystostomy

Cited by 6 publications

References 49 publications

Laparoscopic Cholecystectomy in Acute Cholecystitis: An Updated Review

Laparoscopic Cholecystectomy in Acute Cholecystitis: An Updated Review

Textbook outcome in urgent early cholecystectomy for acute calculous cholecystitis: results post hoc of the S.P.Ri.M.A.C.C study

Impact of percutaneous cholecystostomy in the management of acute cholecystitis: a retrospective cohort study at a tertiary center

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