Delayed Cholecystectomy for Acute Cholecystitis in Elderly Patients Treated Primarily with Antibiotics or Percutaneous Drainage of the Gallbladder

Joliat, Gaëtan‐Romain; Longchamp, Grégoire; Pasquier, Céline Du; Denys, Alban; Demartines, Nicolas; Melloul, Emmanuel

doi:10.1089/lap.2018.0092

Cited by 14 publications

(10 citation statements)

References 22 publications

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“…Delayed management may lead the aggravation to severe cholecystitis situations that increases morbidity such as gangrenous changes, perforation, etc. [3]. The Tokyo Guidelines (TG 18), which include criteria that are classified as clinical markers and ultrasonography (USG) findings of inflammation, are often used for diagnosis [4].…”

Section: Introductionmentioning

confidence: 99%

Can we use neutrophil lymphocyte ratio and platelet lymphocyte ratio as a potential biomarker for acute cholecystitis?

Bedel

2019

Ortadogu Tıp Derg

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Section: Introductionmentioning

confidence: 99%

Can we use neutrophil lymphocyte ratio and platelet lymphocyte ratio as a potential biomarker for acute cholecystitis?

Bedel

2019

Ortadogu Tıp Derg

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“…Therefore, whether early cholecystectomy is superior to non-surgical treatment for elderly patients with AC was not determined in this study. However, the mortality and morbidity rate after early cholecystectomy were 0.0 and 11.9%, respectively, which were acceptable considering previous studies on other treatment strategies for AC in elderly patients [16, 17]. Further prospective studies are needed to reveal the preoperative cognitive status and the efficacy of the surgical treatment for elderly patients with AC.…”

Section: Discussionmentioning

confidence: 83%

Dementia in elderly patients undergoing early cholecystectomy for acute cholecystitis: a retrospective observational study

et al. 2019

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Background Dementia often adversely affects postoperative outcomes in surgical patients. This study evaluated postoperative outcomes among elderly patients with and without dementia undergoing early cholecystectomy for acute cholecystitis (AC). Methods A total of 182 patients over 85 years of age who were diagnosed with AC and treated from January 2005 to March 2018 were reviewed retrospectively; 59 patients who underwent early cholecystectomy were enrolled. The complication rates, length of postoperative hospital stay, and rates of routine discharge (i.e., returning to their preoperative living location) were compared between two groups of patients with and without dementia. Results The overall complication rate after early cholecystectomy for AC in 59 patients was 11.9%, and there was no mortality in this series. The median postoperative hospital stay was 9.0 days, and the routine discharge rate was 89.8%. Of the 59 patients, 22 patients (37.3%) had a history of dementia. Complication rates were comparable between the groups, despite the rate of delirium development being significantly higher in the dementia group. The median length of postoperative hospital stay and routine discharge rates did not significantly differ between groups. Conclusions Early cholecystectomy for patients with AC over 85 years of age was performed safely, and elderly patients with dementia had similar postoperative outcomes as compared with patients without dementia.

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“…The association between complications and the interval from PTGBD to cholecystectomy has previously been discussed in small studies. 4,6,[8][9][10]18,19 An earlier report showed that intervals of <72 h was associated with a higher incidence of postoperative complications, compared with intervals of 72 h. 5 Another existing report showed comparable results for postoperative complications for patients with intervals of <10 days and those with intervals of 10 days. 19 Other previous reports comparing early cholecystectomy without PTGBD and delayed cholecystectomy, performed with intervals of >4-6 weeks following PTGBD, showed a lower incidence of complications in the delayed cholecystectomy group.…”

Section: Discussionmentioning

confidence: 99%

“…2,3 PTGBD is selected to avoid urgent surgery in highrisk patients and is an effective procedure to relieve symptoms from acute cholecystitis. 4 Subsequent cholecystectomy is required if the patient can tolerate surgery because of high a recurrence rate of acute cholecystitis. Acute inflammation, adhesion, and fibrous change are the main concerns when surgeons determine the timing of cholecystectomy.…”

Section: Introductionmentioning

confidence: 99%

Timing of cholecystectomy after percutaneous transhepatic gallbladder drainage for acute cholecystitis: a nationwide inpatient database study

Sakamoto

Fujiogi

Matsui

et al. 2020

HPB

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Background: Optimal interval from percutaneous transhepatic gallbladder drainage (PTGBD) to cholecystectomy for acute cholecystitis remains unclear.Methods: We analyzed patients undergoing cholecystectomy following PTGBD for acute cholecystitis, using a national database. We performed restricted cubic spline (RCS) analyses to investigate the association of interval from PTGBD to cholecystectomy with outcomes (mortality/morbidity, blood transfusion, duration of anesthesia, and postoperative hospital stay).Results: Among 9,256 patients, RCS analyses showed reverse J-shaped associations of the interval with mortality/morbidity and blood transfusion, and J-shaped associations of the interval with both duration of anesthesia and postoperative hospital stay. Each interval was compared with the bottom of the spline curve. Patients with intervals 6 days or 27 days had higher mortality/morbidity than those with a 10-day interval. Patients with intervals 8 days had higher proportions of blood transfusion than those with a 10-day interval. Patients with intervals 17 days had longer duration of anesthesia than those with a 5-day interval. Postoperative hospital stay was longer among those with intervals 10 days or 19 days than those with a 15-day interval.Conclusions: Based on the mortality/morbidity data, the optimum time to perform cholecystectomy is between 7 and 26 days after PTGBD.

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Delayed Cholecystectomy for Acute Cholecystitis in Elderly Patients Treated Primarily with Antibiotics or Percutaneous Drainage of the Gallbladder

Abstract: In elderly patients with acute cholecystitis, DC can be a good alternative to EC. However, after percutaneous drainage DC is associated with high complication rate and long hospital stay.

Cited by 14 publications

References 22 publications

Can we use neutrophil lymphocyte ratio and platelet lymphocyte ratio as a potential biomarker for acute cholecystitis?

Can we use neutrophil lymphocyte ratio and platelet lymphocyte ratio as a potential biomarker for acute cholecystitis?

Dementia in elderly patients undergoing early cholecystectomy for acute cholecystitis: a retrospective observational study

Timing of cholecystectomy after percutaneous transhepatic gallbladder drainage for acute cholecystitis: a nationwide inpatient database study

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