Outcomes of early cholecystectomy (within 7 days of admission) for acute cholecystitis according to diagnosis and severity grading by Tokyo 2013 Guideline
İsmail Sert1, Fuat İpekci2, Ömer Engin3, Muharrem Karaoğlan2, Özhan Çetindağ2
1Clinic of General Surgery and Transplantation, Tepecik Training and Research Hospital, İzmir, Turkey
2Clinic of General Surgery, Tepecik Training and Research Hospital, İzmir, Turkey
3Clinic of General Surgery, Buca Seyfi Demirsoy State Hospital, İzmir, Turkey
Abstract
Objective: The timing of early cholecystectomy in acute cholecystitis is still controversial, and data regarding the use of Tokyo 2013 guideline for diagnosis and severity grading in Acute Cholecystitis is limited. The aim of this study was to evaluate the clinical and pathologic outcomes of early cholecystectomy after 72 hr and within seven days of index admission according to Tokyo 2013 guideline for diagnosis and severity grading of Acute cholecystitis (in patients with Acute cholecystitis.
Material and Methods: Medical charts of 172 patients who underwent early cholecystectomy after 72 hr and within 7 days of index admission with a diagnosis of Acute cholecystitis between Aug 2009 and Apr 2014 were retrospectively analyzed. Patients were classified according Tokyo 2013 guideline criteria.
Results: The median age of the study group was 52 yr. The rates of open and laparoscopic cholecystectomies was 53.5% and 33.1%, respectively. Conversion to open cholecystectomy was performed in 19 patients (13.4 %). The median length of hospital stay was 7 days. Eighty-four patients (59.2%) met the criteria for a definite diagnosis of Acute cholecystitis according to Tokyo 2013 guideline. Longer postoperative and total length of hospital stay was determined in patients with a definite diagnosis.
Conclusion: Increased severity grading is correlated with longer pre- and post-operative hospital stay. Early cholecystectomy in Acute cholecystitis performed by experienced surgeons after 72 hr of admission and within 7 days maybe a feasible and safe procedure.
Keywords: Acute cholecystitis, diagnosis, early cholecystectomy, Tokyo 2013 guideline, severity grading
This study was presented at the 20th National Congress of Surgery, 13-17 April 2016, Antalya, Turkey.
Cite this paper as: Sert İ, İpekci F, Engin Ö, Karaoğlan M, Çetindağ Ö. Outcomes of early cholecystectomy (within 7 days of admission) for acute cholecystitis according to diagnosis and severity grading by Tokyo 2013 Guideline. Turk J Surg 2017; 33(2): 80-86
Ethics committee approval was received for this study from the local ethic committee of Tepecik Training and Research Hospital.
Informed consent was not received due to the retrospective nature of the study.
Externally peer-reviewed.
Concept - İ.S.; Design - İ.S., Ö.Ç.; Supervision - İ.S., F.İ.; Data Collection and/or Processing - İ.S., M.K., Ö.E.; Analysis and/or Interpretation - İ.S., Ö.Ç.; Literature Search - İ.S., M.K., Ö.E.; Writing Manuscript - İ.S., Ö.Ç.; Critical Reviews - İ.S., F.İ.
No conflict of interest was declared by the authors.
The authors declared that this study has received no financial support.