Acute cholecystitis surgery: Difference between revisions

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===Percutaneous cholecystostomy===  
===Percutaneous cholecystostomy===  
Percutaneous cholecystostomy (PC) is an alternative to emergency cholecystectomy in complicated cases of high-risk patients.<ref name="pmid24679431">{{cite journal |vauthors=Knab LM, Boller AM, Mahvi DM |title=Cholecystitis |journal=Surg. Clin. North Am. |volume=94 |issue=2 |pages=455–70 |year=2014 |pmid=24679431 |doi=10.1016/j.suc.2014.01.005 |url=}}</ref><ref name="pmid28603584">{{cite journal |vauthors=Gomes CA, Junior CS, Di Saverio S, Sartelli M, Kelly MD, Gomes CC, Gomes FC, Corrêa LD, Alves CB, Guimarães SF |title=Acute calculous cholecystitis: Review of current best practices |journal=World J Gastrointest Surg |volume=9 |issue=5 |pages=118–126 |year=2017 |pmid=28603584 |pmc=5442405 |doi=10.4240/wjgs.v9.i5.118 |url=}}</ref>
Percutaneous cholecystostomy (PC) is an alternative to emergency cholecystectomy in complicated cases of high-risk patients.<ref name="pmid24679431">{{cite journal |vauthors=Knab LM, Boller AM, Mahvi DM |title=Cholecystitis |journal=Surg. Clin. North Am. |volume=94 |issue=2 |pages=455–70 |year=2014 |pmid=24679431 |doi=10.1016/j.suc.2014.01.005 |url=}}</ref><ref name="pmid28603584">{{cite journal |vauthors=Gomes CA, Junior CS, Di Saverio S, Sartelli M, Kelly MD, Gomes CC, Gomes FC, Corrêa LD, Alves CB, Guimarães SF |title=Acute calculous cholecystitis: Review of current best practices |journal=World J Gastrointest Surg |volume=9 |issue=5 |pages=118–126 |year=2017 |pmid=28603584 |pmc=5442405 |doi=10.4240/wjgs.v9.i5.118 |url=}}</ref><ref name="pmid26580708">{{cite journal |vauthors=Yeo CS, Tay VW, Low JK, Woon WW, Punamiya SJ, Shelat VG |title=Outcomes of percutaneous cholecystostomy and predictors of eventual cholecystectomy |journal=J Hepatobiliary Pancreat Sci |volume=23 |issue=1 |pages=65–73 |year=2016 |pmid=26580708 |doi=10.1002/jhbp.304 |url=}}</ref>
*The results showed that the mortality, morbidity and conversion rate were the same in PC and Laparoscopic cholecystectomy.
*The results showed that the mortality, morbidity and conversion rate were the same in PC and Laparoscopic cholecystectomy.
*Older patients with increased comorbidities usually undergo cholecystostomy.
*Older patients with increased comorbidities usually undergo cholecystostomy.

Revision as of 20:08, 12 December 2017

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Furqan M M. M.B.B.S[2]

Overview

Surgery is the mainstay of treatment for acute cholecystitis (calculous and acalculous). Usually, laparoscopic cholecystectomy is preferred over the open cholecystectomy.

Surgery

  • Surgery is the mainstay of treatment for acute cholecystitis (calculous and acalculous).[1][2][3]
    • Laparoscopic cholecystectomy is considered the gold standard procedure for the treatment of acute cholecystitis.
  • Early cholecystectomy (EC) is usually preferred over delayed cholecystectomy (DC).[4][5][6][7][8]
    • Patients undergoing EC have following advantages over DC:[8]
      • Shorter hospital stays
      • Lower costs
      • No risk of emergency cholecystectomy
    • EC has the following limitations:[8]
      • Increased intraoperative complications
      • Increased postoperative complications

Lapascopic cholecystectomy

There are two main types of procedures used for the laparoscopic cholecystectomy; Single-incision laparoscopic cholecystectomy (SILC) and conventional multiport laparoscopic cholecystectomy (CMLC).[9][10][11][12]

  • Single-incision laparoscopic cholecystectomy (SILC)
    • As compared to CMLC, SILC has the following features:
      • Improved cosmetic results
      • Decreased postoperative pain
      • Increased operative time
      • Increased intraoperative blood loss
  • Conventional multiport laparoscopic cholecystectomy (CMLC)
    • As compared to SILC, CMLC has the following features:
      • Decreased operative time
      • Decreased intraoperative blood loss

Percutaneous cholecystostomy

Percutaneous cholecystostomy (PC) is an alternative to emergency cholecystectomy in complicated cases of high-risk patients.[1][13][14]

  • The results showed that the mortality, morbidity and conversion rate were the same in PC and Laparoscopic cholecystectomy.
  • Older patients with increased comorbidities usually undergo cholecystostomy.
  • If a patient is not a good surgical candidate at the time of presentation, cholecystostomy is preferred. Patients usually have biliary complications and cholecystectomy is required ultimately.

References

  1. 1.0 1.1 Knab LM, Boller AM, Mahvi DM (2014). "Cholecystitis". Surg. Clin. North Am. 94 (2): 455–70. doi:10.1016/j.suc.2014.01.005. PMID 24679431.
  2. Soper NJ, Stockmann PT, Dunnegan DL, Ashley SW (1992). "Laparoscopic cholecystectomy. The new 'gold standard'?". Arch Surg. 127 (8): 917–21, discussion 921–3. PMID 1386505.
  3. Foard DE, Haber AH (1970). "Physiologically normal senescence in seedlings grown without cell division after massive gamma-irradiation of seeds". Radiat. Res. 42 (2): 372–80. PMID 5442405.
  4. Lo CM, Liu CL, Fan ST, Lai EC, Wong J (1998). "Prospective randomized study of early versus delayed laparoscopic cholecystectomy for acute cholecystitis". Ann. Surg. 227 (4): 461–7. PMC 1191296. PMID 9563529.
  5. Johansson M, Thune A, Blomqvist A, Nelvin L, Lundell L (2003). "Management of acute cholecystitis in the laparoscopic era: results of a prospective, randomized clinical trial". J. Gastrointest. Surg. 7 (5): 642–5. PMID 12850677.
  6. Lai PB, Kwong KH, Leung KL, Kwok SP, Chan AC, Chung SC, Lau WY (1998). "Randomized trial of early versus delayed laparoscopic cholecystectomy for acute cholecystitis". Br J Surg. 85 (6): 764–7. doi:10.1046/j.1365-2168.1998.00708.x. PMID 9667702.
  7. Kolla SB, Aggarwal S, Kumar A, Kumar R, Chumber S, Parshad R, Seenu V (2004). "Early versus delayed laparoscopic cholecystectomy for acute cholecystitis: a prospective randomized trial". Surg Endosc. 18 (9): 1323–7. doi:10.1007/s00464-003-9230-6. PMID 15803229.
  8. 8.0 8.1 8.2 Ozkardeş AB, Tokaç M, Dumlu EG, Bozkurt B, Ciftçi AB, Yetişir F, Kılıç M (2014). "Early versus delayed laparoscopic cholecystectomy for acute cholecystitis: a prospective, randomized study". Int Surg. 99 (1): 56–61. doi:10.9738/INTSURG-D-13-00068.1. PMC 3897343. PMID 24444271.
  9. Sato N, Yabuki K, Shibao K, Mori Y, Tamura T, Higure A, Yamaguchi K (2014). "Risk factors for a prolonged operative time in a single-incision laparoscopic cholecystectomy". HPB (Oxford). 16 (2): 177–82. doi:10.1111/hpb.12100. PMC 3921014. PMID 23557447.
  10. Antoniou SA, Pointner R, Granderath FA (2011). "Single-incision laparoscopic cholecystectomy: a systematic review". Surg Endosc. 25 (2): 367–77. doi:10.1007/s00464-010-1217-5. PMID 20607556.
  11. Leung D, Yetasook AK, Carbray J, Butt Z, Hoeger Y, Denham W, Barrera E, Ujiki MB (2012). "Single-incision surgery has higher cost with equivalent pain and quality-of-life scores compared with multiple-incision laparoscopic cholecystectomy: a prospective randomized blinded comparison". J. Am. Coll. Surg. 215 (5): 702–8. doi:10.1016/j.jamcollsurg.2012.05.038. PMID 22819642.
  12. Pisanu A, Reccia I, Porceddu G, Uccheddu A (2012). "Meta-analysis of prospective randomized studies comparing single-incision laparoscopic cholecystectomy (SILC) and conventional multiport laparoscopic cholecystectomy (CMLC)". J. Gastrointest. Surg. 16 (9): 1790–801. doi:10.1007/s11605-012-1956-9. PMID 22767084.
  13. Gomes CA, Junior CS, Di Saverio S, Sartelli M, Kelly MD, Gomes CC, Gomes FC, Corrêa LD, Alves CB, Guimarães SF (2017). "Acute calculous cholecystitis: Review of current best practices". World J Gastrointest Surg. 9 (5): 118–126. doi:10.4240/wjgs.v9.i5.118. PMC 5442405. PMID 28603584.
  14. Yeo CS, Tay VW, Low JK, Woon WW, Punamiya SJ, Shelat VG (2016). "Outcomes of percutaneous cholecystostomy and predictors of eventual cholecystectomy". J Hepatobiliary Pancreat Sci. 23 (1): 65–73. doi:10.1002/jhbp.304. PMID 26580708.

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