Delayed Laparoscopic Cholecystectomy for Acute Calculous Cholecystitis: Is it Time for a Change?

Yuval, Jonathan B.; Mizrahi, Ido; Mazeh, Haggi; Weiss, Daniel J.; Almogy, Gidon; Bala, Miklosh; Kuchuk, Eran; Siam, Baha; Simanovsky, Natalia; Eid, Ahmed; Pikarsky, Alon J.

doi:10.1007/s00268-017-3928-4

Cited by 11 publications

(8 citation statements)

References 41 publications

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“…Figure 1 shows the modified PRISMA flowchart for identification and inclusion of relevant papers. Twentythree studies were excluded from the meta-analysis; 10 papers were deemed low quality [53][54][55][56][57][58][59][60][61] and 13 papers did not provide readmission rates specific to LC [62][63][64][65][66][67][68][69][70][71][72][73][74].…”

Section: Resultsmentioning

confidence: 99%

Readmission to hospital following laparoscopic cholecystectomy: a meta-analysis

McIntyre¹,

Johnston²,

Foley³

et al. 2020

ait

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Biliary disease and cholecystitis remain one of the most significant surgical challenges. Over 1,000,000 cholecystectomies are performed in the US every year [1, 2], and over 50,000 in the UK [3]. While minimally invasive laparoscopic cholecystectomy (LC) has afforded great advantages over open cholecystectomy, reducing variability and improving outcomes remains a challenge [4, 5]. It is only recently that operative classifications and grading of cholecystitis have been published [6]. LC related peri-operative complications, while infrequent may

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Section: Resultsmentioning

confidence: 99%

Readmission to hospital following laparoscopic cholecystectomy: a meta-analysis

McIntyre¹,

Johnston²,

Foley³

et al. 2020

ait

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“…In cholecystitis without septic shock, 30-day mortality has been reported to be between 0.6% and 1.1%. 18,19 In patients with acute cholecystitis with associated organ dysfunction, Yokoe and colleagues reported in a multicentre study that mortality ranged from 3.1% to 25% depending on the number of organ failures present. 20 Anderson and colleagues reported in a multicentre database study of patients with acalculous cholecystitis that sepsis had a hazard ratio (HR) of 1.72 and shock had an HR of 2.07 for mortality.…”

Section: Comparison With the Literaturementioning

confidence: 99%

The impact of delayed source control and antimicrobial therapy in 196 patients with cholecystitis-associated septic shock: a cohort analysis

Karvellas

Dong

Abraldes

et al. 2019

cjs

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Background: Cholecystitis-associated septic shock carries a significant mortality. Our aim was to determine whether timing of source control affects survival in cholecystitis patients with septic shock. Methods:We conducted a nested cohort study of all patients with cholecystitisassociated septic shock from an international, multicentre database (1996)(1997)(1998)(1999)(2000)(2001)(2002)(2003)(2004)(2005)(2006)(2007)(2008)(2009)(2010)(2011)(2012)(2013)(2014)(2015). Multivariable logistic regression was performed to determine associations between clinical factors and in-hospital mortality. The results were used to inform a classification and regression tree (CART) analysis that modelled the association between disease severity (APACHE II), time to source control and survival.Results: Among 196 patients with cholecystitis-associated septic shock, overall mortality was 37%. Compared with nonsurvivors (n = 72), survivors (n = 124) had lower mean admission APACHE II scores (21 v. 27, p < 0.001) and lower median admission serum lactate (2.4 v. 6.8 µmol/L, p < 0.001). Survivors were more likely to receive appropriate antimicrobial therapy earlier (median 2.8 v. 6.1 h from shock, p = 0.012). Survivors were also more likely to undergo successful source control earlier (median 9.8 v. 24.7 h from shock, p < 0.001). Adjusting for covariates, APACHE II (odds ratio [OR] 1.13, 95% confidence interval [CI] 1.06-1.21 per increment) and delayed source control > 16 h (OR 4.45, 95% CI 1.88-10.70) were independently associated with increased mortality (all p < 0.001). The CART analysis showed that patients with APACHE II scores of 15-26 benefitted most from source control within 16 h (p < 0.0001). Conclusion:In patients with cholecystitis-associated septic shock, admission APACHE II score and delay in source control (cholecystectomy or percutaneous chole cystostomy drainage) significantly affected hospital outcomes.Contexte : Le choc septique associé à une cholécystite s'accompagne d'une mortalité significative. Notre but était de déterminer si le moment du contrôle de la source affecte la survie chez les patients atteints de cholécystite qui se trouvent en choc septique.Méthodes : Nous avons procédé à une étude de cohorte nichée regroupant tous les patients ayant présenté un choc septique associé à une cholécystite à partir d'une base de données multicentrique internationale (1996)(1997)(1998)(1999)(2000)(2001)(2002)(2003)(2004)(2005)(2006)(2007)(2008)(2009)(2010)(2011)(2012)(2013)(2014)(2015). La régression logistique multivariée a été utilisée pour déterminer les liens entre les facteurs cliniques et la mortalité perhospitalière. Les résultats ont été utilisés pour éclairer une analyse par arbre de classification (CART) qui modélisait le lien entre la gravité de la maladie (APACHE II), le temps nécessaire au contrôle de la source et la survie.Résultats : Parmi 196 patients souffrant d'un choc septique associé à une cholécystite, la mortalité globale a été de 37 %. Comparativement aux patients décédés (n = 72), les survivants (n = ...

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“…10 A recent study from Israel shows a conversion rate of 5.8%. 11 In another study by Kumar et.al from Utarpardesh India shows a conversion rate of 4.5% 12 and another study from Palpa, Nepal shows a conversion rate of 6.9%. 13 When we compared our conversion rate to the local and international literature we found that our conversion rate was far less than the local and international eviedence available.…”

Section: Discussionmentioning

confidence: 89%

Safe Completion of Laparoscopic Cholecystectomy and Its Conversion Rate in a Tertiary Care Hospital

Farooq

Altaf²,

Qureshi³

et al. 2017

Annals KEMU

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Objectives: Laparoscopic cholecystectomy is a very good and safe procedure for the removal of gall bladder. The objective of our study was to see the conversion rate of laparoscopic cholecystectomy in our unit.Methods: This is a retrospective descriptive study. We conducted this study on 167 patients who under-went gall bladder removal in our unit at a Public sector hospital of Lahore.Results: Our study showed that 163 (97.6%) out of 167 patients had safe complete laparoscopic cholecystectomy while 4 (2.4%) had to be converted to open cholecystectomy. About 40% of the procedures completed by laparoscope were difficult. Approximately 98% were completed by consultants and 42% weresafely performed by the senior registrars.Conclusion: Gall bladder surgery can be safely completed with laparoscope with good team effort and self-awareness of team.

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Delayed Laparoscopic Cholecystectomy for Acute Calculous Cholecystitis: Is it Time for a Change?

Cited by 11 publications

References 41 publications

Readmission to hospital following laparoscopic cholecystectomy: a meta-analysis

Readmission to hospital following laparoscopic cholecystectomy: a meta-analysis

The impact of delayed source control and antimicrobial therapy in 196 patients with cholecystitis-associated septic shock: a cohort analysis

Safe Completion of Laparoscopic Cholecystectomy and Its Conversion Rate in a Tertiary Care Hospital

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