Is cholecystectomy the treatment of choice for acute acalculous cholecystitis? A systematic review of the literature

Soria-Aledo, Víctor; L, Iñiguez; Funes, Diego; Prats, Milagros Carrasco; Albasini, José Luis Aguayo

doi:10.17235/reed.2017.4902/2017

Cited by 23 publications

(16 citation statements)

References 26 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Long‐term follow‐up monitoring, which was performed in our patients, also confirmed these observations. The observation seems to be very important for surgeons who make determinations about cholecystectomy in children with EBV …”

Section: Discussionmentioning

confidence: 98%

Epstein‐Barr virus infection with acute acalculous cholecystitis in previously healthy children

Mazur‐Melewska¹,

Derwich²,

Mania³

et al. 2019

Int J Clin Pract

View full text Add to dashboard Cite

Background Acute acalculous cholecystitis (AAC), an inflammatory process of the gallbladder (GB) in the absence of gallstones, typically occurs in seriously ill patients. AAC can complicate primary Epstein‐Barr virus (EBV) infection, but it is an atypical clinical presentation. Aim The aim of our study was to analyse AAC occurrence in children with primary symptomatic EBV infection who had been admitted to the hospital. Methods We retrospectively evaluated the medical documentation of 181 children with EBV infection who were diagnosed based on the presence of viral capsid antigen IgM antibodies. All EBV‐positive patients underwent transabdominal ultrasonography of the liver in the supine and right anterior oblique positions. Fifteen children who presented with AAC symptoms, including abdominal pain and a positive Murphy's sign, were analysed as a subsample and re‐evaluated after 2‐3 months. Results The incidence of AAC in children hospitalised with infectious mononucleosis (IM) was estimated at 8.3%. Analysis of the laboratory results confirmed that the C‐reactive protein (CRP) concentration was the only parameter which was higher in children who presented with AAC symptoms. The mean number of leucocytes and monocytes and liver enzyme activities were not significantly higher. The radiological findings of AAC were evident: increased GB wall thickness, non‐shadowing echogenic sludge and pericholecystic fluid collection. Conclusion AAC during primary EBV infection appears to be a more common pathology than previously suspected. Its relatively mild nature and the lack of laboratory abnormalities mean that ultrasonographic examination is required for diagnosis. This might explain why the prevalence in children is underestimated.

show abstract

Section: Discussionmentioning

confidence: 98%

Epstein‐Barr virus infection with acute acalculous cholecystitis in previously healthy children

Mazur‐Melewska¹,

Derwich²,

Mania³

et al. 2019

Int J Clin Pract

View full text Add to dashboard Cite

show abstract

“…There are studies suggesting that PC may be a definitive therapy for acute acalculous cholecystitis with no need for subsequent elective cholecystectomy 17 . It appears safe to avoid interval cholecystectomy in patients who recover from acalculous cholecystitis, as they are typically highrisk surgical candidates 18 .…”

Section: Discussionmentioning

confidence: 99%

Percutaneous Cholecystostomy as an Alternative to Cholecystectomy in High-Risk Patients with Acute Cholecystitis

Tosun¹,

Yener²,

Ekinci³

et al. 2019

AJTES

View full text Add to dashboard Cite

Background: Cholecystectomy is the standard treatment for patients with acute cholecystitis. On the other hand, percutaneous cholecystostomy (PC) is an alternative for patients at high-risk for surgery. The aim of this study was to evaluate the clinical outcomes of PC. Methods: Surgically high-risk patients with acute cholecystits having undergone PC at our institution between January 2014 – January 2017 were evaluated. Data including the indications for PC, route of insertion, technical success, clinical improvement, length of hospital stay, mortality rates, procedure related complications, subsequent admissions and performance of interval cholecystectomy were recorded and analyzed. Results: The study group consisted of 30 patients with a mean age of 75.3 ( range: 49–99) years. The indications for PC were acute calculous cholecystitis in 28 (93.3%) and acalculous cholecystitis in 2 (6.7%) patients. All procedures were performed via the transhepatic route. Twenty-five PCs (84.4%) resulted in clinical improvement within five days. A repeated PC was performed in two (6.7%) patients. Seven (23.3%) patients underwent a subsequent cholecystectomy after 6 weeks. An emergent cholecystectomy was performed in one (3.3%) patient. Five (16.7%) patients died from underlying comorbid diseases, unrelated to the biliary system, during the follow-up. Conclusions: Patients with acute cholecystitis were promptly relieved from their symptoms following PC. There were only minor complications following the procedure and an interval cholecystectomy was necessary in only 23.3% of the patients. PC is a safe alternative to choecystectomy in high-risk patients with acute cholecystitis with satisfactory results.

show abstract

“…Our overall mortality figures are significantly better compared to the similar studies published in the literature (13). In a systematic review on treatment of choice for ACC, Soria et al observed that mortality among patients with ACC is 30%, and it is related to clinical severity and higher prevalence of gangrene (50%) and perforation (10%) (14). In our series, mortality was significantly higher in patients with ACC compared to AC, which we think is mainly due to underlying associated co-morbidities.…”

Section: Discussionmentioning

confidence: 99%

Percutaneous Cholecystostomy for Severe Acute Cholecystitis: A Useful Procedure in High-Risk Patients for Surgery

et al. 2018

View full text Add to dashboard Cite

show abstract

Is cholecystectomy the treatment of choice for acute acalculous cholecystitis? A systematic review of the literature

Cited by 23 publications

References 26 publications

Epstein‐Barr virus infection with acute acalculous cholecystitis in previously healthy children

Epstein‐Barr virus infection with acute acalculous cholecystitis in previously healthy children

Percutaneous Cholecystostomy as an Alternative to Cholecystectomy in High-Risk Patients with Acute Cholecystitis

Percutaneous Cholecystostomy for Severe Acute Cholecystitis: A Useful Procedure in High-Risk Patients for Surgery

Contact Info

Product

Resources

About