Año 2022 / Volumen 114 / Número 4
Original
Days of symptoms and days of hospital admission before surgery do not influence the results of cholecystectomy in moderate acute calculous cholecystitis—Cholecystectomy remains the best treatment

213-218

DOI: 10.17235/reed.2020.7405/2020

Jaume Tur-Martínez, Alfredo Escartín, Pablo Muriel, Marta González, Elena Cuello, Ana Pinillos, Helena Salvador, Jorge Juan Olsina,

Resumen
Background and Aims: early cholecystectomy is the gold-standard treatment for acute calculous cholecystitis (ACC), although many surgeons still prefer delayed cholecystectomy for grade II to avoid surgical complications. The aim of this study was to analyze the postoperative morbidity and mortality of Tokyo Guidelines grade-II ACC as treated with cholecystectomy, taking into account the days of symptoms and days since hospital admission. Materials and Methods: a unicenter, retrospective study was performed based on a prospective database. Patients with grade-II ACC treated with cholecystectomy were selected. Patients were analyzed according to days of symptoms (DS) and days of hospital admission (DHA) until cholecystectomy. Patients were subdivided into 3 groups: < 3 days, 3-5 days, and > 5 days. Univariate and multivariate analyses were performed for morbidity and mortality. Categorical variables were compared using the Chi-squared or Fischer's exact test. Continuous variables were compared using the Mann-Whitney U-test. The level of statistical significance was set at p < 0.05. Results: a total of 998 patients with ACC diagnosis were included; 567 with grade-II ACC and 368 treated with cholecystectomy. Nearly 90 % were treated laparoscopically and 48.1 % underwent surgery the same day of emergency admission. With regard to DS and DHA, there were no statistical differences for severe postoperative complications, although a greater number of complications were detected in the > 5 DS group (p: 0.32) and > 5 DHA group (p: 0.00). Statistically significant differences were found in DS for mortality (p: 0.04). Postoperative length of stay was longer for > 5 DHA group cholecystectomies (p > 0.05). There were no differences with regard to hospital readmission. Conclusion: with regard to DS or DHA until cholecystectomy, there were no statistically significant differences related to severe postoperative complications, length of stay, or mortality.
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Bibliografía
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Tur-Martínez J, Escartín A, Muriel P, González M, Cuello E, Pinillos A, et all. Days of symptoms and days of hospital admission before surgery do not influence the results of cholecystectomy in moderate acute calculous cholecystitis—Cholecystectomy remains the best treatment. 7405/2020


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Recibido: 13/07/2020

Aceptado: 16/10/2020

Prepublicado: 03/12/2020

Publicado: 07/04/2022

Tiempo de revisión del artículo: 79 días

Tiempo de prepublicación: 143 días

Tiempo de edición del artículo: 633 días


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