Laparoscopic cholecystectomy: which predicting factors of conversion? Two Italian center's studies

Vaccari, Samuele; Cervellera, Maurizio; Lauro, Augusto; Palazzini, G; Cirocchi, Roberto; Gjata, Arben; Dibra, Arvin; Ussia, Alessandro; Brighi, Manuela; Isaj, Elton; Agastra, Ervis; Casella, Giovanni; Matteo, F M Di; Santoro, A; Falvo, L; Tarroni, D; D’Andrea, Vito; Tonini, Valeria

doi:10.23736/s0026-4733.20.08228-0

Cited by 10 publications

(6 citation statements)

References 62 publications

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“…[13] Does delayed LC after ERCP increase open conversion rates? We found in the article by Vaccari et al [22] that history of ERCP (P = .16; odds ratio [OR] = 1.7) was a risk factor for open conversion rate. In our study, we saw that the conversion rate was higher in ERCP-LC1 (≤3 days) and 2 (3-7 days) than elective LC, although the difference was not statistically significant.…”

Section: Discussionmentioning

confidence: 95%

A retrospective cohort study on the optimal interval between endoscopic retrograde cholangiopancreatography and laparoscopic cholecystectomy

et al. 2022

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Endoscopic retrograde cholangiopancreatography (ERCP) and laparoscopic cholecystectomy (LC) are the most important procedures for patients with choledocholithiasis and gallstones. Many studies recommend early LC after ERCP; however, there is still no consensus on the optimal interval between the two. The purpose of this study was to investigate the appropriate timing of LC after ERCP in patients with choledocholithiasis and cholecystolithiasis.We retrospectively reviewed all ERCPs in our institution from November 2014 to August 2021. All eligible 261 patients were divided into ERCP-LC1 (≤3 days), ERCP-LC2 (3-7 days), and ERCP-LC3 (>7 days). We also reviewed 90 patients with elective LC as the LC group. Procedures, treatment outcomes, and postoperative adverse events were evaluated.In a total of 1642 ERCPs, 261 eligible patients were divided into ERCP-LC1 (n = 102), ERCP-LC2 (n = 113), and ERCP-LC3 (n = 46). The ERCP-LC groups had no difference in operation time, postoperative adverse events, and open conversion rate with the LC group, but the total hospital stay and hospital stay after LC were longer than the LC group. There were no differences between the ERCP-LC groups in operation time, hospital stay after LC, open conversion rate, postoperative adverse events, and efficacy. However, LC within 7 days and even 3 days after ERCP had significant advantages in improvement in total length of stay and medical expenses. Furthermore, we also found an increased risk of gallbladder gangrene and perforation in LC >7 days after ERCP.LC within 7 days and even 3 days after ERCP is a safe, effective, and economical method for patients with choledocholithiasis and gallstones.

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Section: Discussionmentioning

confidence: 95%

A retrospective cohort study on the optimal interval between endoscopic retrograde cholangiopancreatography and laparoscopic cholecystectomy

et al. 2022

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“…For this reason, we performed a multivariable analysis of the covariates, as well as stratified analysis of age, hypertension, DM, and dyslipidemia. Fourth, clinical setting (elective vs. emergency cholecystectomy) or surgical methods (open vs. laparoscopic cholecystectomy) or the presence or absence of the complications may have affected patient’s health after cholecystectomy [ 50 ], but information on the indication of cholecystectomy, surgical methods, and postoperative complications was lacking in the health insurance claims database. To minimize this, a 1-year lag period was set.…”

Section: Discussionmentioning

confidence: 99%

Risk of Heart Disease after Cholecystectomy: A Nationwide Population-Based Cohort Study in South Korea

Kim

Park

Shin

et al. 2021

JCM

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The aim of the study is to evaluate the risk of heart disease in individuals who underwent cholecystectomy. This was a retrospective cohort study using the National Health Insurance Service database of South Korea. A total of 146,928 patients who underwent cholecystectomy and 268,502 age- and sex-matched controls were compared. Multivariate Cox proportional hazard regression analysis was used to estimate the hazard ratio (HR) and 95% confidence interval (CI) for heart disease after cholecystectomy. In results, a previous history of cholecystectomy increased the risk of heart disease (congestive heart failure [CHF], myocardial infarction [MI], atrial fibrillation [AF]) (adjusted HR [aHR]: 1.40, 95% CI: [1.36–1.44]). The increased risk was particularly seen for CHF (1.22 [1.16–1.29]) but not for MI and AF (p > 0.05). In the subgroup analyses, cholecystectomy was associated with an increased risk of MI in patients aged <65 years (1.49 [1.16–1.92] and 1.18 [1.05–1.35] in patients aged 40–49 and 50–64 years, respectively), but not in those aged ≥ 65 years (0.932 [0.838–1.037]). Moreover, the risk of MI was increased in patients without diabetes mellitus (DM) (1.16 [1.06–1.27]); however, it was decreased in patients with DM (0.83 [0.72–0.97]). In contrast, cholecystectomy did not modify the risk of AF in the subgroup analyses (all p > 0.05). In conclusion, a history of cholecystectomy is associated with an increased risk of CHF. Cholecystectomy may increase the risk of MI in the younger population without DM. These findings suggest that the alteration of bile metabolism and homeostasis might be potentially associated with the development of some heart diseases.

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“…Once the gold standard for the treatment of acute cholecystitis, interval cholecystectomy is increasingly abandoned in favor of index admission laparoscopic cholecystectomy (39). This is due to studies that revealed that in trained hands early cholecystectomy is as safe as delayed surgery and that after one episode of cholecystitis the risk of developing calculi-related complications is 14% at 6 weeks, 19% at 12 weeks, and 29% at one year following discharge (39)(40)(41)(42)(43)(44). Traditionally, critically ill surgical patients with acute cholecystitis should be temporized with percutaneous cholecystostomy, but there are data suggesting that in patients with organ failure, temporizing is associated with poorer outcomes and higher mortality compared to those in whom surgery is not deferred (40)(41)(42).…”

Section: Severity Forms and Risk For Conversion In Diabetic Patientsmentioning

confidence: 99%

Clinical and therapeutic features of acute cholecystitis in diabetic patients

et al. 2021

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The present study aimed to compare the clinical, paraclinical, intraoperative findings, and postoperative complications in acute cholecystitis in diabetic patients vs. non-diabetic patients. A 2-year retrospective study was performed on the patients who underwent emergency cholecystectomy for acute cholecystitis between 2017 and 2019 at the 4th Department of Surgery, Emergency University Hospital Bucharest. The diabetic subgroup numbered 46 eligible patients and the non-diabetic one 287 patients. Demographics, the severity of the clinical forms, biological variables (including white cell count, urea, creatinine, coagulation and liver function tests) comorbidity status, surgical approach, postoperative complications, and hospital stay were analyzed. Statistical analyses were performed to assess comparative results between the aforementioned data (SPSS V 13.0). The CCI and ASA risk classes were increased in the diabetic group, with 34.78% of patients having 3 or more associated comorbidities. No statistically significant associations were demonstrated between diabetes and the severity of the cholecystitis and risk for conversion. Postoperatively both minor complications such as surgical site infections and major cardiovascular events were more common in the diabetic subgroup (P=0.0254), well associated with the preoperative status and baseline cardiovascular comorbidities.Laparoscopic cholecystectomy is a safe procedure for diabetic patients, which can provide the best outcomes, by decreasing the risks of surgical wounds. Attentive perioperative care and good glycemic control must be provided to minimize the risk of complications.

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Laparoscopic cholecystectomy: which predicting factors of conversion? Two Italian center's studies

Cited by 10 publications

References 62 publications

A retrospective cohort study on the optimal interval between endoscopic retrograde cholangiopancreatography and laparoscopic cholecystectomy

A retrospective cohort study on the optimal interval between endoscopic retrograde cholangiopancreatography and laparoscopic cholecystectomy

Risk of Heart Disease after Cholecystectomy: A Nationwide Population-Based Cohort Study in South Korea

Clinical and therapeutic features of acute cholecystitis in diabetic patients

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