Annals of medicine and surgery (2012) · 2018
Efficacy and safety of early cholecystectomy for comorbid acute cholecystitis and acute cholangitis: Retrospective cohort study.
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Abe Tomoyuki, Amano Hironobu, Hanada Keiji, Bekki Tomoaki, Minami Tomoyuki, Yonehara Shuji, Noriyuki Toshio, Nakahara Masahiro
Аннотация
BACKGROUND: This study investigated the optimal timing and usefulness of early cholecystectomy for acute cholecystitis in patients with comorbid acute cholangitis.
MATERIALS AND METHODS: In 2011-2016, 252 patients who underwent early cholecystectomy for acute cholecystitis and 7 who underwent delayed cholecystectomy were enrolled and compared. Patients with comorbid acute cholangitis were then divided into those who underwent urgent cholecystectomy (within 72 h after symptom onset), semi-urgent cholecystectomy (3-14 days after symptom onset), or delayed cholecystectomy (3 months after symptom onset).
RESULTS: There were no significant intergroup differences in postoperative complication rate (p = 0.561), operation time (p = 0.496), or intraoperative blood loss (p = 0.151) between those with and those without acute cholangitis. Postoperative stays were significantly longer in the comorbid acute cholangitis group (p = 0.004). In the patients with acute cholangitis, the urgent cholecystectomy, semi-urgent, and delayed cholecystectomy groups had comparable intra- and postoperative outcomes.
CONCLUSION: Early cholecystectomy within 14 days after symptom onset was safely performed for patients with concomitant acute cholecystitis and acute cholangitis after the successful treatment of acute cholangitis.
MATERIALS AND METHODS: In 2011-2016, 252 patients who underwent early cholecystectomy for acute cholecystitis and 7 who underwent delayed cholecystectomy were enrolled and compared. Patients with comorbid acute cholangitis were then divided into those who underwent urgent cholecystectomy (within 72 h after symptom onset), semi-urgent cholecystectomy (3-14 days after symptom onset), or delayed cholecystectomy (3 months after symptom onset).
RESULTS: There were no significant intergroup differences in postoperative complication rate (p = 0.561), operation time (p = 0.496), or intraoperative blood loss (p = 0.151) between those with and those without acute cholangitis. Postoperative stays were significantly longer in the comorbid acute cholangitis group (p = 0.004). In the patients with acute cholangitis, the urgent cholecystectomy, semi-urgent, and delayed cholecystectomy groups had comparable intra- and postoperative outcomes.
CONCLUSION: Early cholecystectomy within 14 days after symptom onset was safely performed for patients with concomitant acute cholecystitis and acute cholangitis after the successful treatment of acute cholangitis.