What is the optimal time for laparoscopic cholecystectomy in gallbladder empyema?

Kwon, Yong Jin; Ahn, Byung Kyu; Park, Hwon Kyum; Lee, Kwang Soo; Lee, Kyeong Geun

doi:10.1007/s00464-013-2968-6

Cited by 17 publications

(13 citation statements)

References 23 publications

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“…Laparoscopy encourages more patients who are expecting cosmoses and early return to work to undergo surgery. Recently, there was a trend to operate in the initial admission of acute phase of cholecystitis [3], [4]. Laparoscopic cholecystectomy indications have increased substantially to include: patients with liver cirrhosis, old patients and patients with absolute contraindication to open surgery [5].…”

Section: Introductionmentioning

confidence: 99%

Subtotal laparoscopic cholecystectomy influences the rate of conversion in patients with difficult laparoscopic cholecystectomy: Case series

Abdelrahim

El-Siddig

Wahab

et al. 2017

Annals of Medicine &Amp; Surgery

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ObjectivesThis study aimed to show that subtotal laparoscopic cholecystectomy (SLC) is a safe procedure that reduces the rate of conversion in patients with difficult laporoscopic cholecystectomies in resource-meagre settings.Patients and methodsFollowing informed consent, patients with gallstones reporting to Atbara Medical Centre, Atbara, Northern Sudan from February 2012 to July 2013 were managed laparoscopically except those with choledocholithiasis. SLC was done for patients with difficult cholecystectomy and obscured Callot's triangle. Clinical presentation, duration of symptoms, ultrasound findings, frequency of conversion to open operation, frequency of difficult cholecystectomy, operation duration and numbers/types of complications were recorded. Statistical analysis was carried out using SPSS.ResultsOne hundred and nine patients with a median age of 48 years, F:M ratio of 9 and mean duration of symptoms of 14.8 ± 12.9 months were enrolled. A quarter (29/109, 26.6%) had acute choleycystitis, 13% had difficult laparoscopic cholecystectomy. SLC was done for 16.2%. Retained stones were statistically significant in patients who underwent subtotal laparoscopic cholecystectomy (p = 0.02) with a conversion rate of 5.5%.ConclusionSLC is feasible, safe and can reduce the rate of conversion for patients with difficult laporoscopic cholecystectomy. Sub-total laparoscopic cholecystectomy is not a substitute to conversion and in difficult conditions it is not a failure for the surgeon but a wisdom.

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Section: Introductionmentioning

confidence: 99%

Subtotal laparoscopic cholecystectomy influences the rate of conversion in patients with difficult laparoscopic cholecystectomy: Case series

Abdelrahim

El-Siddig

Wahab

et al. 2017

Annals of Medicine &Amp; Surgery

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“…1,2 Recent analyses are in favor of early surgery, which seems to be feasible and safe, and it offers both medical and socioeconomic benefits compared with delayed-interval surgery. 3–7 As a result, delayed surgery is now chosen under certain situations, such as a prolonged time from onset to presentation, patient's comorbidity and age, and emergency medical system in each hospital, among other reasons. LC for AC is surgery with a high degree of surgical difficulty, and surgeons sometimes encounter difficult cases that require conversion.…”

Section: Introductionmentioning

confidence: 99%

Risk Factors for Difficult Laparoscopic Cholecystectomy in Acute Cholecystitis

Hayama¹,

Ohtaka²,

Shoji³

et al. 2016

JSLS

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Background and Objectives:Factors that contribute to difficult laparoscopic cholecystectomy (LC) in acute cholecystitis (AC) that would affect the performance of early surgery remain unclear. The purpose of this study was to identify such risk factors.Methods:One hundred fifty-four patients who underwent LC for AC were retrospectively analyzed. The patients were categorized into early surgery and delayed surgery. Factors predicting difficult LC were analyzed for each group. The operation time, bleeding, and cases of difficult laparoscopic surgery (CDLS)/conversion rate were analyzed as an index of difficulty. Analyses of patients in the early group were especially focused on 3 consecutive histopathological phases: edematous cholecystitis (E), necrotizing cholecystitis (N), suppurative/subacute cholecystitis (S).Results:In the early group, the CDLS/conversion rate was highest in necrotizing cholecystitis. Its rate was significantly higher than that of the other 2 histopathological types (N 27.9% vs E and S 7.4%; P = .037). In the delayed-surgery group, a higher white blood cell (WBC) count and older age showed significant correlations with the CDLS/conversion rate (P = .034 and P = .004).Conclusion:In early surgery, histopathologic necrotizing cholecystitis is a risk factor for difficult LC in AC. A higher WBC count and older age are risk factors for delayed surgery.

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“…Delayed laparoscopic cholecystitis (LC) was preferred for AC in the past, out of fear higher complication rate because of increased local inflammation and difficulty in dissection of Calot's triangle [1]. Several recent trials of early cholecystectomy have shown improved surgical results in parameters such as operation time, amount of bleeding, and conversion rate compared with delayed interval cholecystectomy [2][3][4]. The Japanese clinical guidelines for treating AC, proposed in 2005, provide criteria not only for diagnosis, but also for management depending on disease severity [5].…”

Section: Introductionmentioning

confidence: 99%

“…In the Japanese guidelines in 3 2005, early surgery is defined as operation within 96 h after symptom onset [5]. Thereafter, early surgery was defined within 72 h after symptom onset based on Tokyo guidelines (TG)13 [8], and other large studies favoring early cholecystectomy have recommended surgery within 48-72 h of admission [2][3][4]. However, those reports did not perform assessments based on the duration from symptom onset, and patients who underwent the operation >96 h after the development of AC but within 72 h of admission would thus still have been included in the "early" group.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of early cholecystectomy for acute cholecystitis within 10 days of onset, with arguments based on histopathological findings

Hayama¹,

Fujita²,

Senmaru³

et al. 2020

Preprint

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Background: Histopathological findings would impact the timing of early cholecystectomy, but no reports have yet discussed. The aim of this study is to examine the feasible timing for early cholecystectomy based on both conventional clinicopathological data and histopathological findings. Methods: We retrospectively analyzed 127 patients who underwent laparoscopic cholecystectomy for acute cholecystitis (AC) at in our institutes between 2010 and 2015. Patients were categorized into two groups according to the interval between surgery and symptom onset (early, £96 h; delayed, >96 h) for comparison of clinical results. In addition, both histopathological findings and clinical results were compared between the early group (£96 h) and a sub-delayed subgroup of patients who underwent cholecystectomy at >96 h but ≦240 h. Results: No significant differences in surgical results were seen between the early group and delayed group. In terms of histopathological findings, the sub-delayed subgroup showed significant phase progression of cholecystitis compared to the early group. However, edema in the gallbladder (GB) wall was comparable in all cases operated on within 240 h, mirroring the lack of significant differences in surgical results seen between early and sub-delayed subgroups. Conclusion: Edema in the GB wall with AC is continuous within 10 days from onset, and emergency laparoscopic cholecystectomy within this period is safe and feasible.

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What is the optimal time for laparoscopic cholecystectomy in gallbladder empyema?

Cited by 17 publications

References 23 publications

Subtotal laparoscopic cholecystectomy influences the rate of conversion in patients with difficult laparoscopic cholecystectomy: Case series

Subtotal laparoscopic cholecystectomy influences the rate of conversion in patients with difficult laparoscopic cholecystectomy: Case series

Risk Factors for Difficult Laparoscopic Cholecystectomy in Acute Cholecystitis

Evaluation of early cholecystectomy for acute cholecystitis within 10 days of onset, with arguments based on histopathological findings

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