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- Title
Timing of Early Cholecystectomy for Acute Calculous Cholecystitis: A Multicentric Prospective Observational Study.
- Authors
Fugazzola, Paola; Abu-Zidan, Fikri M.; Cobianchi, Lorenzo; Dal Mas, Francesca; Ceresoli, Marco; Coccolini, Federico; Frassini, Simone; Tomasoni, Matteo; Catena, Fausto; Ansaloni, Luca
- Abstract
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.
- Subjects
ACALCULOUS cholecystitis; RESEARCH; KRUSKAL-Wallis Test; STATISTICS; SCIENTIFIC observation; TIME; SURGICAL complications; FISHER exact test; CHOLECYSTECTOMY; TREATMENT effectiveness; RISK assessment; DESCRIPTIVE statistics; DATA analysis; ACUTE diseases; LONGITUDINAL method; DISEASE risk factors
- Publication
Healthcare (2227-9032), 2023, Vol 11, Issue 20, p2752
- ISSN
2227-9032
- Publication type
Article
- DOI
10.3390/healthcare11202752