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Cholecystectomy for acute cholecystitis. How time-critical are the so called "golden 72 hours"? Or better "golden 24 hours" and "silver 25-72 hour"? A case control study.

Ambe P, Weber SA, Christ H, Wassenberg D - World J Emerg Surg (2014)

Bottom Line: There were no significant differences in the duration of surgery, postoperative complications, rate of conversion and length of hospital stay.Immediate laparoscopic cholecystectomy for acute cholecystitis within 24 hour of symptom onset is not superior to surgery 25-72 hour after symptoms begin.Laparoscopic cholecystectomy for acute cholecystitis therefore can be safely performed anytime within the golden 72 h.

View Article: PubMed Central - PubMed

Affiliation: Helios Klinikum Wuppertal, Department of Surgery II, Witten/Herdecke University, Heusner Strasse 40, 42283 Wuppertal, Germany ; Department of General, visceral and thoracic surgery, St. Remigius Hospital Opladen, An St. Remigius 26, 51379 Leverkusen, Germany.

ABSTRACT

Introduction: Early cholecystectomy within 72 hours has been shown to be superior to late or delayed cholecystectomy with regard to outcome and cost of treatment. Recently, immediate cholecystectomy within 24 hours of onset of symptom was proposed as standard procedure for the management of fit patients presenting with acute cholecystitis. We sort to find out if there are any differences in surgical outcomes between patients managed within 24 h and those managed 25-72 h following symptom begin for acute cholecystitis.

Patients and methods: A retrospective analysis was performed. The outcomes of patients undergoing laparoscopic cholecystectomy within 24 h were compared to those of patients managed 25-72 h following symptom onset for acute cholecystitis.

Results: 35 patients managed 25-72 h following begin of symptoms were matched with 35 patients with similar baseline features, medical comorbidities and disease severity managed within 24 hours of symptom onset. There were no significant differences in the duration of surgery, postoperative complications, rate of conversion and length of hospital stay.

Conclusion: Immediate laparoscopic cholecystectomy for acute cholecystitis within 24 hour of symptom onset is not superior to surgery 25-72 hour after symptoms begin. Laparoscopic cholecystectomy for acute cholecystitis therefore can be safely performed anytime within the golden 72 h.

No MeSH data available.


Related in: MedlinePlus

Distribution of the study population. 35 Patients undergoing surgery 25-72 h following symptom begin were compared to 35 selected patients with similar demographic and clinical parameter from the groups managed within 24 h of symptom onset.
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Fig1: Distribution of the study population. 35 Patients undergoing surgery 25-72 h following symptom begin were compared to 35 selected patients with similar demographic and clinical parameter from the groups managed within 24 h of symptom onset.

Mentions: Within the period of investigation 152 cases of AC were managed surgically. The distribution of study population is represented in Figure 1. Thirty-five patients were managed within 25-72 h following symptom begin (study group). Thirty-five patients with similar characteristics to those of the study group were selected from the 105 patients managed within 24 h of symptom begin, Table 1. The demographic characteristics of the study population are summarized in Table 2. Both groups were comparable in all cases.Figure 1


Cholecystectomy for acute cholecystitis. How time-critical are the so called "golden 72 hours"? Or better "golden 24 hours" and "silver 25-72 hour"? A case control study.

Ambe P, Weber SA, Christ H, Wassenberg D - World J Emerg Surg (2014)

Distribution of the study population. 35 Patients undergoing surgery 25-72 h following symptom begin were compared to 35 selected patients with similar demographic and clinical parameter from the groups managed within 24 h of symptom onset.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4274710&req=5

Fig1: Distribution of the study population. 35 Patients undergoing surgery 25-72 h following symptom begin were compared to 35 selected patients with similar demographic and clinical parameter from the groups managed within 24 h of symptom onset.
Mentions: Within the period of investigation 152 cases of AC were managed surgically. The distribution of study population is represented in Figure 1. Thirty-five patients were managed within 25-72 h following symptom begin (study group). Thirty-five patients with similar characteristics to those of the study group were selected from the 105 patients managed within 24 h of symptom begin, Table 1. The demographic characteristics of the study population are summarized in Table 2. Both groups were comparable in all cases.Figure 1

Bottom Line: There were no significant differences in the duration of surgery, postoperative complications, rate of conversion and length of hospital stay.Immediate laparoscopic cholecystectomy for acute cholecystitis within 24 hour of symptom onset is not superior to surgery 25-72 hour after symptoms begin.Laparoscopic cholecystectomy for acute cholecystitis therefore can be safely performed anytime within the golden 72 h.

View Article: PubMed Central - PubMed

Affiliation: Helios Klinikum Wuppertal, Department of Surgery II, Witten/Herdecke University, Heusner Strasse 40, 42283 Wuppertal, Germany ; Department of General, visceral and thoracic surgery, St. Remigius Hospital Opladen, An St. Remigius 26, 51379 Leverkusen, Germany.

ABSTRACT

Introduction: Early cholecystectomy within 72 hours has been shown to be superior to late or delayed cholecystectomy with regard to outcome and cost of treatment. Recently, immediate cholecystectomy within 24 hours of onset of symptom was proposed as standard procedure for the management of fit patients presenting with acute cholecystitis. We sort to find out if there are any differences in surgical outcomes between patients managed within 24 h and those managed 25-72 h following symptom begin for acute cholecystitis.

Patients and methods: A retrospective analysis was performed. The outcomes of patients undergoing laparoscopic cholecystectomy within 24 h were compared to those of patients managed 25-72 h following symptom onset for acute cholecystitis.

Results: 35 patients managed 25-72 h following begin of symptoms were matched with 35 patients with similar baseline features, medical comorbidities and disease severity managed within 24 hours of symptom onset. There were no significant differences in the duration of surgery, postoperative complications, rate of conversion and length of hospital stay.

Conclusion: Immediate laparoscopic cholecystectomy for acute cholecystitis within 24 hour of symptom onset is not superior to surgery 25-72 hour after symptoms begin. Laparoscopic cholecystectomy for acute cholecystitis therefore can be safely performed anytime within the golden 72 h.

No MeSH data available.


Related in: MedlinePlus