The severity grading of acute cholecystitis following the Tokyo Guidelines is the most powerful predictive factor for conversion from laparoscopic cholecystectomy to open cholecystectomy

Bouassida, Mounir; Chtourou, Mohamed Fadhel; Charrada, H.; Zribi, S.; Hamzaoui, Lamine; Mighri, Mohamed Mongi; Touinsi, Hassen

doi:10.1016/j.jviscsurg.2016.11.007

Cited by 22 publications

(19 citation statements)

References 31 publications

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“…A total of 15 articles analyzed diabetes as a risk factor for conversion from laparoscopic to open surgery. in 10 studies diabetes was found to increase this conversion rate [6,10,[25][26][27][28][29][30][31][32]. On the contrary, in 5 studies did not show that diabetes significantly affected the risk of conversion [16,[33][34][35][36].…”

Section: Complicationsmentioning

confidence: 99%

Acute cholecystitis in patients with diabetes mellitus - systematic review

Łącka¹,

Spychalski²,

Dobrzycka³

et al. 2020

Eur J Trans Clin Med

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Introduction: According to the WHO, an estimated 422 million people are suffering from diabetes worldwide. Among them, the incidence of cholelithiasis is higher than in the healthy population. The aim of this literature review was to summarize the available evidence about acute cholecystitis in patients with diabetes. Materials and methods: This study adhered to the PRISMA guidelines. The course of hospitalization of patients with and without diabetes who underwent cholecystectomy due to acute cholecystitis was compared.Following information was abstracted from original studies: general study information, patient characteristics, complications, and recommendations for patients with diabetes. Results: Initial search provided 1632 results. After full text assessment, 40 studies met the inclusions criteria. Operative and postoperative complication rates were significantly higher among the diabetic patients. Diabetes is a risk factor for conversion from laparoscopic to open cholecystectomy method. The authors' opinions on elective surgery before the onset of acute cholecystitis symptoms are divided. Conclusions: Diabetic patients are at greater risk of developing complications. An individualized screening and treatment approach, as well as proper preparation of the diabetic patient for an elective cholecystectomy could have a positive effect on the outcome. However, the low quality of the data from the systematic review does not allow for meta-analysis, which is why we cannot draw strong conclusions.

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Section: Complicationsmentioning

confidence: 99%

Acute cholecystitis in patients with diabetes mellitus - systematic review

Łącka¹,

Spychalski²,

Dobrzycka³

et al. 2020

Eur J Trans Clin Med

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“…Thus, ASA scores were used for measuring the performance status, and for predicting the risk related to LC surgery, consistent with the strategy adopted in previous studies [7,15]. For evaluating the severity of AC, TG grading system was followed [10], and it was observed that super-elderly patients frequently had higher ASA scores and TG grades compared with elderly patients. However, there was no significant difference between both groups in terms of ASA score or TG grade-associated clinical outcomes.…”

Section: Discussionmentioning

confidence: 98%

“…TG severity grading reportedly plays an important role in the outcome of LC [10] and open conversion cholecystectomy is also an important factor [11,12]. The factors affecting the outcome of LC increase postoperative complications, mortality rates, and length of hospital stay, leading to economic losses [13].…”

Section: Discussionmentioning

confidence: 99%

Clinical Safety of Laparoscopic Cholecystectomy in Elderly Patients: A Comparison of Clinical Outcomes in Patients Aged 65 to 79 Years and over 80 Years

et al. 2020

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IntroductionThe incidence of acute cholecystitis (AC) increases with age, ranging from 20% to 30% among elderly individuals, and up to 80% among institutionalized elderly patients aged > 90 years. Furthermore, > 90% AC cases are closely associated with cholelithiasis [1]. A previous study has shown that the prevalence of gallstones and AC is correlated with age [2]. The standard treatment of AC is laparoscopic cholecystectomy (LC) in young adults [3]. However, the safety of LC for elderly patients remains controversial owing to them having increased comorbidity risks [4]. Reduced physiologic reserve increases the risk of morbidity and mortality in elderly patients. High rates of morbidity and mortality make it challenging for surgeons to select an optimal operative management strategy [5]. Thus, many clinicians considered percutaneous biliary drainage to avoid administration of general anesthesia and surgery [6]. However, there was no clinical evidence to support this concern. Recently, perioperative care for elderly patients and LC technique has been improved, which reduces the risk associated with LC. The demand of surgery for AC has increased, and thus there is a need to evaluate the clinical safety and efficacy of LC in super-elderly patients (≥ 80 years) compared with elderly patients (≤ 65-79 years).

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“…Bouassida et al and Utsumi et al showed that the independent risk factors for conversion to open surgery included male sex, diabetes mellitus, total bilirubin level and TG13 grade. TG13 (Tokyo classification 2013) grade was found to be the most powerful predictive factor for conversion as it had the highest OR [27,28] .…”

Section: Discussionmentioning

confidence: 99%

When should a surgeon think to convert laparoscopic cholecystectomy to open surgery? A Retrospective Study

Ferlengez¹

2019

Haydarpasa Numune Med J

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Introduction: Today, it is still a difficult decision for surgeons to convert from laparoscopic cholecystectomy (LC) to Open cholecystectomy (OC). Our aim in this study is to predict the possibility of conversion to OC before the operation by comparing the data of the patients who underwent LC. Methods: Patients were divided into two groups. The first group was the OC group and the second group was the LC group. The data of both groups were compared with various parameters. Results: The conversion rate from LC to OC was 7.2%. The rate of conversion in male patients was 12.8%, and the rate of conversion in female patients was 5.2%. The mean age of the group with OC (52.66±13.77) was statistically higher (p=0.019 <0.05) than the laparoscopy group (47.22±13.04). Discussion and Conclusion: Regarding patients' age, gender, increased alkaline phosphatase, gamma-glutamyl transferase and direct bilirubin values, gallbladder wall thickness, presence of bile sludge and presence or suspicion of choledocholithiasis, preoperative endoscopic retrograde cholangiography history parameters as a risk factor in the group OC, there were statistically significant relation.

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The severity grading of acute cholecystitis following the Tokyo Guidelines is the most powerful predictive factor for conversion from laparoscopic cholecystectomy to open cholecystectomy

Abstract: The independent risk factors for conversion to open surgery included male sex, diabetes mellitus, total bilirubin level, and TG13 grade. TG13 grade was found to be the most powerful predictive factor for conversion as it had the highest OR.

Cited by 22 publications

References 31 publications

Acute cholecystitis in patients with diabetes mellitus - systematic review

Acute cholecystitis in patients with diabetes mellitus - systematic review

Clinical Safety of Laparoscopic Cholecystectomy in Elderly Patients: A Comparison of Clinical Outcomes in Patients Aged 65 to 79 Years and over 80 Years

When should a surgeon think to convert laparoscopic cholecystectomy to open surgery? A Retrospective Study

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