scholarly journals Erratum to: 2016 WSES guidelines on acute calculous cholecystitis

2016 ◽  
Vol 11 (1) ◽  
Author(s):  
L. Ansaloni ◽  
M. Pisano ◽  
F. Coccolini ◽  
A. B. Peitzmann ◽  
A. Fingerhut ◽  
...  
Keyword(s):  
Acute Calculous Cholecystitis ◽  
Calculous Cholecystitis ◽  
Wses Guidelines

scholarly journals P-BN42 Percutaneous cholecystostomy - A practice review

2021 ◽  
Vol 108 (Supplement_9) ◽  
Author(s):  
Wing Ching Li ◽  
Omar Elboraey ◽  
Mohammad Saeed Kilani ◽  
Kishore Gopaldas Pursnani ◽  
Ilayaraja Rajendran
Keyword(s):  
Current Practice ◽  
Percutaneous Cholecystostomy ◽  
Specific Patient ◽  
Acute Calculous Cholecystitis ◽  
Global Pandemic ◽  
Practice Review ◽  
Patient Groups ◽  
Selection For ◽  
Calculous Cholecystitis ◽  
Wses Guidelines

Abstract Background Percutaneous cholecystostomy (PC) is performed occasionally in a highly selected group of patients with variable outcomes. The World Society of Emergency Surgery (WSES) updated guidelines(2020) has recommended PC as a treatment modality in patients admitted with ‘acute calculous cholecystitis’(ACC) with  who are not fit for surgery, including septic patients and those who show no improvement on conservative management within 48 hours. An audit was organised to review our patient selection for PC in the last 5 years in comparison to the latest WSES recommendations. Methods A retrospective observational study was conducted using a prospectively collected hospital database on patients who underwent PC between March 2016 and March 2021 in a teaching hospital. The patient cohort who underwent PC were compared and analysed against the set WSES guidelines. Results Some 23 patients were included. The median age was 82 years (range-61-90), with 13 females (56.5%) and 10 males (43.5%).19/23(82.6%) patients were at risk of sepsis on presentation, with two or more amber flag symptoms, whereas 4/23(17.4%) patients presented with confirmed sepsis. 19/23 (82.6%) were deemed unfit for surgery against 4/23 who were deemed fit based on the surgeons assessment. Patients unfit for surgery were treated with antibiotics following a diagnosis of ACC. The median time for patients to undergo PC from admission was 4 days. The 30-day mortality rate was 13 % (n = 3/23). Conclusions The study has demonstrated that our current practice for managing patients admitted with ACC and performing PC are mostly in line with the WSES guidelines. Considering individuals presentation and the surgeons clinical judgement into account, the practice was also likely impacted by COVID-19 the global pandemic. Further clinical studies may be required to determine specific patient groups who would benefit from PC.

scholarly journals 2016 WSES guidelines on acute calculous cholecystitis

2017 ◽  
Vol 23 (6) ◽  
pp. 25
Author(s):  
L. Ansaloni ◽  
M. Pisano ◽  
F. Coccolini ◽  
A. B. Peitzmann ◽  
A. Fingerhut ◽  
...  
Keyword(s):  
Acute Calculous Cholecystitis ◽  
Calculous Cholecystitis ◽  
Wses Guidelines

scholarly journals 2016 WSES guidelines on acute calculous cholecystitis

2016 ◽  
Vol 11 (1) ◽  
Author(s):  
L. Ansaloni ◽  
M. Pisano ◽  
F. Coccolini ◽  
A. B. Peitzmann ◽  
A. Fingerhut ◽  
...  
Keyword(s):  
Acute Calculous Cholecystitis ◽  
Calculous Cholecystitis ◽  
Wses Guidelines

scholarly journals Mortality risk estimation in acute calculous cholecystitis: beyond the Tokyo Guidelines

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Ana María González-Castillo ◽  
Juan Sancho-Insenser ◽  
Maite De Miguel-Palacio ◽  
Josep-Ricard Morera-Casaponsa ◽  
Estela Membrilla-Fernández ◽  
...  
Keyword(s):  
Risk Factors ◽  
Surgical Treatment ◽  
Propensity Score ◽  
Mortality Risk ◽  
Characteristic Curve ◽  
Chronic Obstructive ◽  
Tokyo Guidelines ◽  
Acute Calculous Cholecystitis ◽  
Calculous Cholecystitis ◽  
Non Surgical Treatment

Abstract Background Acute calculous cholecystitis (ACC) is the second most frequent surgical condition in emergency departments. The recommended treatment is the early laparoscopic cholecystectomy; however, the Tokyo Guidelines (TG) advocate for different initial treatments in some subgroups of patients without a strong evidence that all patients will benefit from them. There is no clear consensus in the literature about who is the unfit patient for surgical treatment. The primary aim of the study is to identify the risk factors for mortality in ACC and compare them with Tokyo Guidelines (TG) classification. Methods Retrospective unicentric cohort study of patients emergently admitted with and ACC during 1 January 2011 to 31 December 2016. The study comprised 963 patients. Primary outcome was the mortality after the diagnosis. A propensity score method was used to avoid confounding factors comparing surgical treatment and non-surgical treatment. Results The overall mortality was 3.6%. Mortality was associated with older age (68 + IQR 27 vs. 83 + IQR 5.5; P = 0.001) and higher Charlson Comorbidity Index (3.5 + 5.3 vs. 0+2; P = 0.001). A logistic regression model isolated four mortality risk factors (ACME): chronic obstructive pulmonary disease (OR 4.66 95% CI 1.7–12.8 P = 0.001), dementia (OR 4.12; 95% CI 1.34–12.7, P = 0.001), age > 80 years (OR 1.12: 95% CI 1.02–1.21, P = 0.001) and the need of preoperative vasoactive amines (OR 9.9: 95% CI 3.5–28.3, P = 0.001) which predicted the mortality in a 92% of the patients. The receiver operating characteristic curve yielded an area of 88% significantly higher that 68% (P = 0.003) from the TG classification. When comparing subgroups selected using propensity score matching with the same morbidity and severity of ACC, mortality was higher in the non-surgical treatment group. (26.2% vs. 10.5%). Conclusions Mortality was higher in ACC patients treated with non-surgical treatment. ACME identifies high-risk patients. The validation to ACME with a prospective multicenter study population could allow us to create a new alternative guideline to TG for treating ACC. Trial registration Retrospectively registered and recorded in Clinical Trials. NCT04744441

Sign in / Sign up

Export Citation Format

Share Document