High rates of recurrence of gallstone associated episodes following acute cholecystitis during long term follow-up: a retrospective comparative study of patients who did not receive surgery.
Cholecystitis
Non-operative management
Recurrent cholecystitis
Recurrent gallstone-related events
Journal
European journal of trauma and emergency surgery : official publication of the European Trauma Society
ISSN: 1863-9941
Titre abrégé: Eur J Trauma Emerg Surg
Pays: Germany
ID NLM: 101313350
Informations de publication
Date de publication:
Apr 2023
Apr 2023
Historique:
received:
19
07
2022
accepted:
31
08
2022
medline:
15
5
2023
pubmed:
6
10
2022
entrez:
5
10
2022
Statut:
ppublish
Résumé
Patients who are admitted with acute cholecystitis (AC) and do not undergo urgent cholecystectomy, are usually referred for interval cholecystectomy. Many do not have surgery for various reasons, and some of those do not suffer from any recurrent symptoms. The primary objective of this study was to assess the rate and nature of recurrent gallstone-related events in this population over a long period, and its association with demographic and clinical parameters. A secondary objective was to assess the reasons for not undergoing surgery. This is a retrospective cohort study, where the study group were adult patients admitted with AC. Patients that have suffered recurrent episodes were compared with those who did not. A control group of patients that had undergone cholecystectomy following an admission with AC was used for comparison. Demographic and clinical parameters were recorded for all patients, and the association with a recurrent episode was analyzed using univariate analysis. The study population was 197 patients. The group of patients who did not undergo surgery were significantly older (68.7 vs 54.2) and sicker (ASA > 3 50% vs 19%). The rate of recurrent episodes in the study group was 38.5%, and it was not found to be associated with the studied parameters. There was a trend towards higher gallstone disease specific mortality in the study group (5.5% vs 1.45% p = 0.062). This is a study of long-term follow-up of patients following an episode of AC we showed that the rate of recurrent episodes is quite high and involves severe inflammatory diseases, such as obstructive jaundice and pancreatitis.
Identifiants
pubmed: 36197463
doi: 10.1007/s00068-022-02106-7
pii: 10.1007/s00068-022-02106-7
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1157-1161Informations de copyright
© 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany.
Références
Koti RS, Davidson CJ, Davidson BR. Surgical management of acute cholecystitis. Langenbecks Arch Surg. 2015;400(4):403–19. https://doi.org/10.1007/s00423-015-1306-y .
doi: 10.1007/s00423-015-1306-y
pubmed: 25971374
Sanders G, Kingsnorth AN. Gallstones. BMJ. 2007;335(7614):295–9. https://doi.org/10.1136/bmj.39267.452257.AD .
doi: 10.1136/bmj.39267.452257.AD
pubmed: 17690370
pmcid: 1941876
Yamashita Y, Takada T, Strasberg SM, Pitt HA, Gouma DJ, Garden OJ, Büchler MW, Gomi H, Dervenis C, Windsor JA, Kim SW. TG13 surgical management of acute cholecystitis. J Hepatobiliary Pancreat Sci. 2013;20(1):89–96. https://doi.org/10.1007/s00534-012-0567-x .
doi: 10.1007/s00534-012-0567-x
pubmed: 23307007
Shikata S, Noguchi Y, Fukui T. Early versus delayed cholecystectomy for acute cholecystitis: a meta-analysis of randomized controlled trials. Surg Today. 2005;35(7):553–60. https://doi.org/10.1007/s00595-005-2998-3 .
doi: 10.1007/s00595-005-2998-3
pubmed: 15976952
Loozen CS, Oor JE, van Ramshorst B, van Santvoort HC, Boerma D. Conservative treatment of acute cholecystitis: a systematic review and pooled analysis. Surg Endosc. 2017;31(2):504–15. https://doi.org/10.1007/s00464-016-5011-x .
doi: 10.1007/s00464-016-5011-x
pubmed: 27317033
Paran H, Zissin R, Rosenberg E, Griton I, Kots E, Gutman M. Prospective evaluation of patients with acute cholecystitis treated with percutaneous cholecystostomy and interval laparoscopic cholecystectomy. Int J Surg. 2006;4(2):101–5. https://doi.org/10.1016/j.ijsu.2006.01.001 .
doi: 10.1016/j.ijsu.2006.01.001
pubmed: 17462323
Mazeh H, Mizrahi I, Dior U, Simanovsky N, Shapiro M, Freund HR, Eid A. Role of antibiotic therapy in mild acute calculus cholecystitis: a prospective randomized controlled trial. World J Surg. 2012;36(8):1750–9. https://doi.org/10.1007/s00268-012-1572-6 .
doi: 10.1007/s00268-012-1572-6
pubmed: 22456803
Rodríguez-Cerrillo M, Poza-Montoro A, Fernandez-Diaz E, Iñurrieta-Romero A, Matesanz-David M. Home treatment of patients with acute cholecystitis. Eur J Intern Med. 2012;23(1):e10–3. https://doi.org/10.1016/j.ejim.2011.07.012 .
doi: 10.1016/j.ejim.2011.07.012
pubmed: 22153541
Barak O, Elazary R, Appelbaum L, Rivkind A, Almogy G. Conservative treatment for acute cholecystitis: clinical and radiographic predictors of failure. Isr Med Assoc J. 2009;11(12):739–43.
pubmed: 20166341
Cao AM, Eslick GD, Cox MR. Early cholecystectomy is superior to delayed cholecystectomy for acute cholecystitis: a meta-analysis. J Gastrointest Surg. 2015;19(5):848–57. https://doi.org/10.1007/s11605-015-2747-x .
doi: 10.1007/s11605-015-2747-x
pubmed: 25749854
McGillicuddy EA, Schuster KM, Barre K, Suarez L, Hall MR, Kaml GJ, Davis KA, Longo WE. Non-operative management of acute cholecystitis in the elderly. Br J Surg. 2012;99(9):1254–61. https://doi.org/10.1002/bjs.8836 .
doi: 10.1002/bjs.8836
pubmed: 22829411
Hatzidakis AA, Prassopoulos P, Petinarakis I, Sanidas E, Chrysos E, Chalkiadakis G, Tsiftsis D, Gourtsoyiannis NC. Acute cholecystitis in high-risk patients: percutaneous cholecystostomy vs conservative treatment. Eur Radiol. 2002;12(7):1778–84. https://doi.org/10.1007/s00330-001-1247-4 .
doi: 10.1007/s00330-001-1247-4
pubmed: 12111069
Schmidt M, Søndenaa K, Vetrhus M, Berhane T, Eide GE. Long-term follow-up of a randomized controlled trial of observation versus surgery for acute cholecystitis: non-operative management is an option in some patients. Scand J Gastroenterol. 2011;46(10):1257–62. https://doi.org/10.3109/00365521.2011.598548 .
doi: 10.3109/00365521.2011.598548
pubmed: 21736531
De Mestral C, Rotstein OD, Laupacis A, Hoch JS, Zagorski B, Nathens AB. A population-based analysis of the clinical course of 10,304 patients with acute cholecystitis, discharged without cholecystectomy. J Trauma Acute Care Surg. 2013;74(1):26–31. https://doi.org/10.1097/TA.0b013e3182788e4d .
doi: 10.1097/TA.0b013e3182788e4d
pubmed: 23271073
Riall TS, Zhang D, Townsend CM Jr, Kuo YF, Goodwin JS. Failure to perform cholecystectomy for acute cholecystitis in elderly patients is associated with increased morbidity, mortality, and cost. J Am Coll Surg. 2010;210(5):668–77. https://doi.org/10.1016/j.jamcollsurg.2009.12.031 .
doi: 10.1016/j.jamcollsurg.2009.12.031
pubmed: 20421027
pmcid: 2866125
Gurusamy K, Samraj K, Gluud C, Wilson E, Davidson BR. Meta-analysis of randomized controlled trials on the safety and effectiveness of early versus delayed laparoscopic cholecystectomy for acute cholecystitis. Br J Surg. 2010;97(2):141–50. https://doi.org/10.1002/bjs.6870 .
doi: 10.1002/bjs.6870
pubmed: 20035546
Johansson M, Thune A, Blomqvist A, Nelvin L, Lundell L. Management of acute cholecystitis in the laparoscopic era: results of a prospective, randomized clinical trial. J Gastrointest Surg. 2003;7(5):642–5. https://doi.org/10.1016/S1091-255X(03)00065-9 .
doi: 10.1016/S1091-255X(03)00065-9
pubmed: 12850677