TY - JOUR
T1 - Timing of Early Cholecystectomy for Acute Calculous Cholecystitis
T2 - A Multicentric Prospective Observational Study
AU - Fugazzola, Paola
AU - Abu-Zidan, Fikri M.
AU - Cobianchi, Lorenzo
AU - Dal Mas, Francesca
AU - Ceresoli, Marco
AU - Coccolini, Federico
AU - Frassini, Simone
AU - Tomasoni, Matteo
AU - Catena, Fausto
AU - Ansaloni, Luca
N1 - Publisher Copyright:
© 2023 by the authors.
PY - 2023/10
Y1 - 2023/10
N2 - The definition of Early Cholecystectomy (EC) is still debatable. This paper aims to find whether the timing of EC affects outcomes. The article reports a multicentric prospective observational study including patients with acute calculous cholecystitis (ACC) who had cholecystectomy within ten days from the onset of symptoms. Kruskall-Wallis test, Fisher’s Exact test, and Spearman rank correlation were used for statistical analysis. The patients were divided into three groups depending on the timing of the operation: 0–3 days, 4–7 days, or 8–10 days from the onset of symptoms. 1117 patients were studied over a year. The time from the onset of symptoms to EC did not affect the post-operative complications and mortality, the conversion, and the reintervention rate. The time represented a significant risk factor for intraoperative complications (0–3 days, 2.8%; 4–7 days, 5.6%; 8–10 days, 7.9%; p = 0.01) and subtotal cholecystectomies (0–3 days, 2.7%; 4–7 days, 5.6%; 8–10 days, 10.9%; p < 0.001). ACC is an evolutive inflammatory process and, as the days go by, the local and systemic inflammation increases, making surgery more complex and difficult with a higher risk of intraoperative complications. We recommend performing EC for ACC as soon as possible, within the first ten days of the onset of symptoms.
AB - The definition of Early Cholecystectomy (EC) is still debatable. This paper aims to find whether the timing of EC affects outcomes. The article reports a multicentric prospective observational study including patients with acute calculous cholecystitis (ACC) who had cholecystectomy within ten days from the onset of symptoms. Kruskall-Wallis test, Fisher’s Exact test, and Spearman rank correlation were used for statistical analysis. The patients were divided into three groups depending on the timing of the operation: 0–3 days, 4–7 days, or 8–10 days from the onset of symptoms. 1117 patients were studied over a year. The time from the onset of symptoms to EC did not affect the post-operative complications and mortality, the conversion, and the reintervention rate. The time represented a significant risk factor for intraoperative complications (0–3 days, 2.8%; 4–7 days, 5.6%; 8–10 days, 7.9%; p = 0.01) and subtotal cholecystectomies (0–3 days, 2.7%; 4–7 days, 5.6%; 8–10 days, 10.9%; p < 0.001). ACC is an evolutive inflammatory process and, as the days go by, the local and systemic inflammation increases, making surgery more complex and difficult with a higher risk of intraoperative complications. We recommend performing EC for ACC as soon as possible, within the first ten days of the onset of symptoms.
KW - acute cholecystitis
KW - cholecystectomy
KW - complication
KW - mortality
KW - surgery
KW - timing
UR - http://www.scopus.com/inward/record.url?scp=85175369573&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85175369573&partnerID=8YFLogxK
U2 - 10.3390/healthcare11202752
DO - 10.3390/healthcare11202752
M3 - Article
AN - SCOPUS:85175369573
SN - 2227-9032
VL - 11
JO - Healthcare (Switzerland)
JF - Healthcare (Switzerland)
IS - 20
M1 - 2752
ER -