İsmail Sert1, Fuat İpekci2, Ömer Engin3, Muharrem Karaoğlan2, Özhan Çetindağ2. 1. Clinic of General Surgery and Transplantation, Tepecik Training and Research Hospital, İzmir, Turkey. 2. Clinic of General Surgery, Tepecik Training and Research Hospital, İzmir, Turkey. 3. Clinic of General Surgery, Buca Seyfi Demirsoy State Hospital, İzmir, Turkey.
Abstract
OBJECTIVE: The timing of early cholecystectomy in acute cholecystitis is still controversial, and data regarding the use of Tokyo 2013 guideline for diagnosis and severity grading in Acute Cholecystitis is limited. The aim of this study was to evaluate the clinical and pathologic outcomes of early cholecystectomy after 72 hr and within seven days of index admission according to Tokyo 2013 guideline for diagnosis and severity grading of Acute cholecystitis (in patients with Acute cholecystitis. MATERIAL AND METHODS: Medical charts of 172 patients who underwent early cholecystectomy after 72 hr and within 7 days of index admission with a diagnosis of Acute cholecystitis between Aug 2009 and Apr 2014 were retrospectively analyzed. Patients were classified according Tokyo 2013 guideline criteria. RESULTS: The median age of the study group was 52 yr. The rates of open and laparoscopic cholecystectomies was 53.5% and 33.1%, respectively. Conversion to open cholecystectomy was performed in 19 patients (13.4 %). The median length of hospital stay was 7 days. Eighty-four patients (59.2%) met the criteria for a definite diagnosis of Acute cholecystitis according to Tokyo 2013 guideline. Longer postoperative and total length of hospital stay was determined in patients with a definite diagnosis. CONCLUSION: Increased severity grading is correlated with longer pre- and post-operative hospital stay. Early cholecystectomy in Acute cholecystitis performed by experienced surgeons after 72 hr of admission and within 7 days maybe a feasible and safe procedure.
OBJECTIVE: The timing of early cholecystectomy in acute cholecystitis is still controversial, and data regarding the use of Tokyo 2013 guideline for diagnosis and severity grading in Acute Cholecystitis is limited. The aim of this study was to evaluate the clinical and pathologic outcomes of early cholecystectomy after 72 hr and within seven days of index admission according to Tokyo 2013 guideline for diagnosis and severity grading of Acute cholecystitis (in patients with Acute cholecystitis. MATERIAL AND METHODS: Medical charts of 172 patients who underwent early cholecystectomy after 72 hr and within 7 days of index admission with a diagnosis of Acute cholecystitis between Aug 2009 and Apr 2014 were retrospectively analyzed. Patients were classified according Tokyo 2013 guideline criteria. RESULTS: The median age of the study group was 52 yr. The rates of open and laparoscopic cholecystectomies was 53.5% and 33.1%, respectively. Conversion to open cholecystectomy was performed in 19 patients (13.4 %). The median length of hospital stay was 7 days. Eighty-four patients (59.2%) met the criteria for a definite diagnosis of Acute cholecystitis according to Tokyo 2013 guideline. Longer postoperative and total length of hospital stay was determined in patients with a definite diagnosis. CONCLUSION: Increased severity grading is correlated with longer pre- and post-operative hospital stay. Early cholecystectomy in Acute cholecystitis performed by experienced surgeons after 72 hr of admission and within 7 days maybe a feasible and safe procedure.
Entities:
Keywords:
Acute cholecystitis; Tokyo 2013 guideline; diagnosis; early cholecystectomy; severity grading
Authors: Carsten N Gutt; Jens Encke; Jörg Köninger; Julian-Camill Harnoss; Kilian Weigand; Karl Kipfmüller; Oliver Schunter; Thorsten Götze; Markus T Golling; Markus Menges; Ernst Klar; Katharina Feilhauer; Wolfram G Zoller; Karsten Ridwelski; Sven Ackmann; Alexandra Baron; Michael R Schön; Helmut K Seitz; Dietmar Daniel; Wolfgang Stremmel; Markus W Büchler Journal: Ann Surg Date: 2013-09 Impact factor: 12.969