Postoperative Outcome of Early Laparoscopic and Open Cholecystectomy for Acute Calculous Cholecystitis

2016 ◽  
Vol 21 (2) ◽  
pp. 49-53
Author(s):  
Ainul Hadi
Keyword(s):  
Open Cholecystectomy ◽  
Postoperative Outcome ◽  
Acute Calculous Cholecystitis ◽  
Calculous Cholecystitis

scholarly journals ACUTE CALCULOUS CHOLECYSTITIS IN A YOUNG FEMALE PATIENT: A UNIQUE CASE

2019 ◽  
Vol 3 (8) ◽  
Author(s):  
Christina Permata Shalim ◽  
Ni Nengah Tuti Tuti Arianthi ◽  
Made Suma Wirawan
Keyword(s):  
Acute Cholecystitis ◽  
Female Patient ◽  
Open Cholecystectomy ◽  
Patient Characteristics ◽  
Young Female ◽  
Acute Calculous Cholecystitis ◽  
Obese Female ◽  
Upper Abdominal ◽  
Calculous Cholecystitis ◽  
Distended Gallbladder

Acute cholecystitis needs to be rapidly diagnosed and treated correctly. The classic patient characteristics were obese, increasing age, and being female. In a few cases, cholecystitis can occured in an atypical patient, such as in young age. Here, we report a 25-year-old obese female patient that came with right upper abdominal pain which was associated with nausea and vomiting. From imaging studies, we found that she had distended gallbladder with multiple stones. Open cholecystectomy was done and patient did well postoperatively. Acute cholecystitis had to be suspected in all age, especially in patient with another risk factor like obesity in our case. Keywords: acute cholecystitis, gallstone, cholecystectomy

scholarly journals Massive splenic infarction in a patient with acute calculous cholecystitis: a case report and literature review

2019 ◽  
Vol 6 (8) ◽  
pp. 2976
Author(s):  
Alaa Sedik ◽  
Ahmed Fathi ◽  
Mufid Maali ◽  
Salwa Elhoushy ◽  
Shima Morsy
Keyword(s):  
Acute Abdominal Pain ◽  
Open Cholecystectomy ◽  
Good Condition ◽  
Splenic Abscess ◽  
Splenic Infarction ◽  
Uneventful Recovery ◽  
Quadrant Pain ◽  
Acute Calculous Cholecystitis ◽  
Calculous Cholecystitis ◽  
Symptoms And Signs

Massive splenic infarction (MSI) is a rare cause of acute abdominal pain and is attributed to compromised blood flow to more than half of the spleen. It may be due to hematological, non-hematological, or rarely spontaneous. Symptoms and signs are non-specific. Diagnosis is based mainly on radiological investigations. The treatment is splenectomy if complications occur. We reported a case of a 50-year-Saudi lady, who was presented with a picture of acute calculous cholecystitis that was treated conservatively. Then 48 hours later, pain improved significantly, then shortly she suddenly developed a left upper quadrant pain. Computerized tomography of the abdomen diagnosed the situation as MSI. She underwent open cholecystectomy and splenectomy as conservative treatment failed and she developed a splenic abscess. She made uneventful recovery and discharged in a good condition. Hematological, cardiology, and rheumatology services diagnosed the situation as a spontaneous MSI. She was seen in surgery outpatient free of complaints.

scholarly journals RESULTS OF EARLY AND DELAYED LAPAROSCOPIC CHOLECYSTECTOMY IN PATIENTS WITH AN ACUTE CALCULUS CHOLECYSTITIS AND ISCHEMIC HEART DISEASE

2018 ◽  
Vol 13 (3-4) ◽  
pp. 15-21
Author(s):  
V.G. Mishalov ◽  
S.O. Kondratenko ◽  
L.Yu. Markulan
Keyword(s):  
Heart Disease ◽  
Laparoscopic Cholecystectomy ◽  
Ischemic Heart Disease ◽  
Open Cholecystectomy ◽  
Group Versus ◽  
Ischemic Heart ◽  
Acute Calculous Cholecystitis ◽  
Delayed Laparoscopic Cholecystectomy ◽  
Conversion To Open Cholecystectomy ◽  
Calculous Cholecystitis

Relevance. Determination of the optimal time for laparoscopic cholecystectomy (LCE) in patients with acute calculous cholecystitis (ACC) and ischemic heart disease (IHD) is still an actual and unresolved issue. Objective: to evaluate the results early versus delayed LCE in patients with ACC and IHD. Materials and methods. The study involved 107 patients with ACC and IHD: 56 (47,7 %) women and 51 (52,3 %) men aged 55 to 82 years, an average 70,2±0,6 years. The group with early LCE (ELCE) included 48 patients with LCE – up to 72 hours from the beginning of ACC (on average 41,9±2,1 hours), the group with delayed LCE (DLCE) – 59 patients, who were LCE for more than 72 hours (in average 90,2±1,6 hours) from the beginning of ACC. Groups of patients were representative according to the functional classes of heart failure, angina pectoris, severity and the histological form of ACC. All patients had a Charlson comorbidity index from 0 to 2 points. The endpoint of the study were: the frequency of conversion to open cholecystectomy, cardiac events in the intra – and early postoperative periods, the incidence of complications according to the Clavien-Dindo classification. Data analysis was performed using IBM SPSS Statistics. Results.  The duration of LCE in the DLCE group was 45,2±2,1 minutes, in the ELCE group it was 40,9±1,4 min (p=0,115). Conversion to open cholecystectomy was required in 8 (13,6 %) patients of the DLCE group versus one (2,1 %) in the ELCE group, p=0,033. During the operation, myocardial ischemia occurred in 17 (28,8 %) patients of the DLCE group versus 6 (12,5%) the ELCE group, p=0,041, and a systolic blood pressure decrement lower than 70 mm hg. art. – in 24 (40,7 %) against 8 (16,7 %), p=0,007; saturation reduction episodes – in 33 (55,9 %) against 17 (35,4 %), p=0,034, respectively. In the early postoperative period, an increasing of HF class according to NYHA was observed in 12 (20,3 %) patients of the DLCE group versus one (2,1 %) in the ELCE group, p=0.004; the number of patients with complications according to Clavien-Dindo classification – 40 (67,8 %) versus 23 (47,9 %), p=0,038; pneumonia occurred in 26 (44,1 %) against 6 (12,5 %), p=0,001; exudative pleurisy – in 28 (47,5 %) against 9 (18,8 %), p=0,002, respectively. There were no lethal cases in the period up to 7 days in both groups. Conclusion. ELCE is a priority method of treatment patients with an acute calculous cholecystitis (ACC) and ischemic heart disease (IHD) with a different functional class (according to NYHA). Compared with DLCE, it is associated with reliable reduce of conversion (2,1 %), against 8 (13,6 %), intra- and  early postoperative complications of the cardiovascular system and complications according to Clavien-Dindo classification – 23 (47,9 %) patients against 40 (67,8 %).

Acute cholecystitis: predictive clinico-radiological assessment for conversion of laparoscopic cholecystectomy

2020 ◽  
Vol 61 (11) ◽  
pp. 1452-1462
Author(s):  
Young Rock Jang ◽  
Su Joa Ahn ◽  
Seung Joon Choi ◽  
Ki Hyun Lee ◽  
Yeon Ho Park ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Abdominal Surgery ◽  
Prothrombin Time ◽  
Open Cholecystectomy ◽  
Gallbladder Wall ◽  
Acute Calculous Cholecystitis ◽  
Prolonged Prothrombin Time ◽  
Ct Findings ◽  
History Of ◽  
Calculous Cholecystitis

Background Previous studies evaluating predictive factors for the conversion from laparoscopic to open cholecystectomy have reported conflicting conclusions. Purpose To create a risk assessment model to predict the conversion from laparoscopic to open cholecystectomy in patients with acute calculous cholecystitis. Material and Methods A retrospective review of patients with acute calculous cholecystitis with available preoperative contrast-enhanced computed tomography (CT) findings who underwent laparoscopic cholecystectomy was performed. Forty-four parameters—including demographics, clinical history, laboratory data, and CT findings—were analyzed. Results Among the included 581 patients, conversion occurred in 113 (19%) cases. Multivariate analysis identified obesity (odd ratio [OR] 2.58, P = 0.04), history of abdominal surgery (OR 1.78, P = 0.03), and prolonged prothrombin time (OR 1.98, P = 0.03) as predictors of conversion. In preoperative CT findings, the absence of gallbladder wall enhancement (OR 3.15, P = 0.03), presence of a gallstone in the gallbladder infundibulum (OR 2.11, P = 0.04), and inflammation of the hepatic pedicle (OR 1.71, P = 0.04) were associated with conversion. Inter-observer agreement for CT study interpretation was very good (range 0.81–1.00). A model was created to calculate the risk for conversion, with an area under the receiver operating characteristic curve of 0.87. The risk for conversion, estimated based on the number of factors identified, was in the range of 5.3% (with one factor) to 86.4% (with six factors). Conclusion Obesity, history of abdominal surgery, prolonged prothrombin time, absence of gallbladder wall enhancement, presence of a gallstone in the gallbladder infundibulum, and inflammation of the hepatic pedicle are associated with conversion of laparoscopic to open cholecystectomy.

scholarly journals FEATURES OF SURGICAL TACTICS OF TREATMENT OF ACUTE CALCULOUS CHOLECYSTITIS OCCURRING AGAINST THE BACKGROUND OF DIABETES MELLITUS

2018 ◽  
Vol 25 (6) ◽  
pp. 90-95
Author(s):  
V. V. Zorik ◽  
G. K. Karipidi ◽  
A. V. Morozov
Keyword(s):  
Diabetes Mellitus ◽  
Laparoscopic Cholecystectomy ◽  
Surgical Treatment ◽  
Postoperative Complications ◽  
Histological Study ◽  
Open Cholecystectomy ◽  
Control Group ◽  
Acute Calculous Cholecystitis ◽  
Patients With Diabetes ◽  
Calculous Cholecystitis

Aim. The study was conducted to improve the results of the surgical treatment of acute calculous cholecystitis occurring against the background of diabetes mellitus. Materials and methods. In course of our study, we analyzed the treatment results of 687 patients with acute calculous cholecystitis. Depending on the presence of diabetes, all patients were divided into two groups. The main group with concomitant diabetes mellitus included 68 (9,9%) patients, whereas the control group without diabetes included 619 (90,1%) patients. Laparoscopic cholecystectomy was performed on 636 (92,6%) patients, and open cholecystectomy was performed on 51 (7,4%) patients. Results. According to the histological study, the greatest number of destructive forms occurs in patients with concomitant diabetes, operated after 24 hours. The least postoperative complications occur in patients of both groups operated from 12 to 24 hours. However, the incidence of complications is 4-5 times higher in patients with diabetes mellitus. Postoperative complications in patients with acute calculous cholecystitis occurring on the background of sugar diabetes were observed after open cholecystectomy in 33,3% of cases and in 6,5% of cases after laparoscopic surgery.Conclusion In patients with acute cholecystitis and concomitant diabetes, surgical treatment should be performed on the first day after the preoperative preparation during the first 12 hours, aimed at compensating for diabetes and improving microcirculation. The preference should be given to laparoscopic cholecystectomy, which reduces the number of postoperative complications by 5 times and mortality by 4.5 times.

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 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

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