Masamichi Yokoe1, Tadahiro Takada2, Tsann-Long Hwang3, Itaru Endo4, Kohei Akazawa5, Fumihiko Miura2, Toshihiko Mayumi6, Rintaro Mori7, Miin-Fu Chen3, Yi-Yin Jan3, Chen-Guo Ker8, Hsiu-Po Wang9, Takao Itoi10, Harumi Gomi11, Seiki Kiriyama12, Keita Wada2, Hiroki Yamaue13, Masaru Miyazaki14, Masakazu Yamamoto15. 1. Department of General Internal Medicine, Japanese Red Cross Nagoya Daini Hospital, Aichi, Japan. 2. Department of Surgery, Teikyo University School of Medicine, Tokyo, Japan. 3. Division of General Surgery, Lin-Kou Chang Gung Memorial Hospital, Tauyuan, Taiwan. 4. Department of Gastroenterological Surgery, Yokohama City University Graduate School of Medicine, Kanagawa, Japan. 5. Department of Medical Informatics, Niigata University, Niigata, Japan. 6. Department of Emergency Medicine, School of Medicine, University of Occupational and Environmental Health, Fukuoka, Japan. 7. Department of Health Policy, National Center for Child Health and Development, Tokyo, Japan. 8. Department of Surgery, Yuan's General Hospital, Kaohsiung, Taiwan. 9. Department of Internal Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan. 10. Department of Gastroenterology and Hepatology, Tokyo Medical University Hospital, Tokyo, Japan. 11. Center for Global Health, Mito Kyodo General Hospital, University of Tsukuba, Ibaraki, Japan. 12. Department of Gastroenterology, Ogaki Municipal Hospital, Gifu, Japan. 13. Second Department of Surgery, Wakayama Medical University, Wakayama, Japan. 14. Emeritus Professor, Graduate School of Medicine, Chiba University, Chiba, Japan. 15. Department of Surgery, Institute of Gastroenterology, Tokyo Women's Medical University, Tokyo, Japan.
Abstract
BACKGROUND: Since the publication of the Tokyo Guidelines (TG13) for the management of acute cholecystitis (AC), multidirectional studies have been published. However, epidemiological research about AC with big data was not projected. The aim of this study was to reveal the actual clinical conditions of AC. METHOD: The study was designed as an international multicenter retrospective study of AC in Japan and Taiwan from 2011 to 2013. The factors investigated comprised data related to demographic, history, physical examinations, laboratory and imaging findings. Based on these data, we investigated the various values of AC, and real situation with respect to severity and treatment. RESULTS: A total of 5,459 patients with AC were reviewed. Thirty-day mortality rate was 1.1%. Based on the diagnostic criteria, 4,088 patients had a definite diagnosis and 291 had a suspected diagnosis. According to the severity grading, 939 patients were classified as Grade III, 2,308 as Grade II, and 2,130 as Grade I. Cholecystectomy was performed in total of 4,266 patients and 2,765 patients had laparoscopic cholecystectomy. The main etiologies were gallbladder stones in 4,623 cases. CONCLUSION: This epidemiological study with large population will undoubtedly contribute to establish the best practice for managing AC worldwide.
BACKGROUND: Since the publication of the Tokyo Guidelines (TG13) for the management of acute cholecystitis (AC), multidirectional studies have been published. However, epidemiological research about AC with big data was not projected. The aim of this study was to reveal the actual clinical conditions of AC. METHOD: The study was designed as an international multicenter retrospective study of AC in Japan and Taiwan from 2011 to 2013. The factors investigated comprised data related to demographic, history, physical examinations, laboratory and imaging findings. Based on these data, we investigated the various values of AC, and real situation with respect to severity and treatment. RESULTS: A total of 5,459 patients with AC were reviewed. Thirty-day mortality rate was 1.1%. Based on the diagnostic criteria, 4,088 patients had a definite diagnosis and 291 had a suspected diagnosis. According to the severity grading, 939 patients were classified as Grade III, 2,308 as Grade II, and 2,130 as Grade I. Cholecystectomy was performed in total of 4,266 patients and 2,765 patients had laparoscopic cholecystectomy. The main etiologies were gallbladder stones in 4,623 cases. CONCLUSION: This epidemiological study with large population will undoubtedly contribute to establish the best practice for managing AC worldwide.
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