Acute cholecystitis surgery: Difference between revisions

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==Overview==
==Overview==
Surgical intervention is not recommended for the management of [disease name].
Surgery is the mainstay of treatment for acute cholecystitis (calculous and acalculous).[[Laparoscopic cholecystectomy]] is the gold standard for the treatment of acute cholecystitis and is usually preferred over the open [[cholecystectomy]]. Percutaneous cholecystostomy (PC) is an alternative to emergency [[cholecystectomy]] in complicated cases of high-risk patients.


OR
==Surgery==
 
*Surgery is the mainstay of treatment for acute cholecystitis (calculous and acalculous).<ref name="pmid24679431">{{cite journal |vauthors=Knab LM, Boller AM, Mahvi DM |title=Cholecystitis |journal=Surg. Clin. North Am. |volume=94 |issue=2 |pages=455–70 |year=2014 |pmid=24679431 |doi=10.1016/j.suc.2014.01.005 |url=}}</ref><ref name="pmid1386505">{{cite journal |vauthors=Soper NJ, Stockmann PT, Dunnegan DL, Ashley SW |title=Laparoscopic cholecystectomy. The new 'gold standard'? |journal=Arch Surg |volume=127 |issue=8 |pages=917–21; discussion 921–3 |year=1992 |pmid=1386505 |doi= |url=}}</ref><ref name="pmid5442405">{{cite journal |vauthors=Foard DE, Haber AH |title=Physiologically normal senescence in seedlings grown without cell division after massive gamma-irradiation of seeds |journal=Radiat. Res. |volume=42 |issue=2 |pages=372–80 |year=1970 |pmid=5442405 |doi= |url=}}</ref><ref name="pmid25971374">{{cite journal |vauthors=Koti RS, Davidson CJ, Davidson BR |title=Surgical management of acute cholecystitis |journal=Langenbecks Arch Surg |volume=400 |issue=4 |pages=403–19 |year=2015 |pmid=25971374 |doi=10.1007/s00423-015-1306-y |url=}}</ref><ref name="pmid27429137">{{cite journal |vauthors=Bagla P, Sarria JC, Riall TS |title=Management of acute cholecystitis |journal=Curr. Opin. Infect. Dis. |volume=29 |issue=5 |pages=508–13 |year=2016 |pmid=27429137 |doi=10.1097/QCO.0000000000000297 |url=}}</ref>
Surgery is not the first-line treatment option for patients with [disease name]. Surgery is usually reserved for patients with either [indication 1], [indication 2], and [indication 3]
**[[Laparoscopic cholecystectomy]] is considered the '''gold standard''' procedure for the treatment of acute cholecystitis.
 
*Early [[cholecystectomy]] (EC) is usually preferred over delayed [[cholecystectomy]] (DC).<ref name="pmid9563529">{{cite journal |vauthors=Lo CM, Liu CL, Fan ST, Lai EC, Wong J |title=Prospective randomized study of early versus delayed laparoscopic cholecystectomy for acute cholecystitis |journal=Ann. Surg. |volume=227 |issue=4 |pages=461–7 |year=1998 |pmid=9563529 |pmc=1191296 |doi= |url=}}</ref><ref name="pmid12850677">{{cite journal |vauthors=Johansson M, Thune A, Blomqvist A, Nelvin L, Lundell L |title=Management of acute cholecystitis in the laparoscopic era: results of a prospective, randomized clinical trial |journal=J. Gastrointest. Surg. |volume=7 |issue=5 |pages=642–5 |year=2003 |pmid=12850677 |doi= |url=}}</ref><ref name="pmid9667702">{{cite journal |vauthors=Lai PB, Kwong KH, Leung KL, Kwok SP, Chan AC, Chung SC, Lau WY |title=Randomized trial of early versus delayed laparoscopic cholecystectomy for acute cholecystitis |journal=Br J Surg |volume=85 |issue=6 |pages=764–7 |year=1998 |pmid=9667702 |doi=10.1046/j.1365-2168.1998.00708.x |url=}}</ref><ref name="pmid15803229">{{cite journal |vauthors=Kolla SB, Aggarwal S, Kumar A, Kumar R, Chumber S, Parshad R, Seenu V |title=Early versus delayed laparoscopic cholecystectomy for acute cholecystitis: a prospective randomized trial |journal=Surg Endosc |volume=18 |issue=9 |pages=1323–7 |year=2004 |pmid=15803229 |doi=10.1007/s00464-003-9230-6 |url=}}</ref><ref name="pmid24444271">{{cite journal |vauthors=Ozkardeş AB, Tokaç M, Dumlu EG, Bozkurt B, Ciftçi AB, Yetişir F, Kılıç M |title=Early versus delayed laparoscopic cholecystectomy for acute cholecystitis: a prospective, randomized study |journal=Int Surg |volume=99 |issue=1 |pages=56–61 |year=2014 |pmid=24444271 |pmc=3897343 |doi=10.9738/INTSURG-D-13-00068.1 |url=}}</ref><ref name="pmid25749854">{{cite journal |vauthors=Cao AM, Eslick GD, Cox MR |title=Early Cholecystectomy Is Superior to Delayed Cholecystectomy for Acute Cholecystitis: a Meta-analysis |journal=J. Gastrointest. Surg. |volume=19 |issue=5 |pages=848–57 |year=2015 |pmid=25749854 |doi=10.1007/s11605-015-2747-x |url=}}</ref>
OR
**Patients undergoing EC have following advantages over DC:<ref name="pmid24444271">{{cite journal |vauthors=Ozkardeş AB, Tokaç M, Dumlu EG, Bozkurt B, Ciftçi AB, Yetişir F, Kılıç M |title=Early versus delayed laparoscopic cholecystectomy for acute cholecystitis: a prospective, randomized study |journal=Int Surg |volume=99 |issue=1 |pages=56–61 |year=2014 |pmid=24444271 |pmc=3897343 |doi=10.9738/INTSURG-D-13-00068.1 |url=}}</ref>
 
***Shorter hospital stays
The mainstay of treatment for [disease name] is medical therapy. Surgery is usually reserved for patients with either [indication 1], [indication 2], and/or [indication 3].
***Lower costs
 
***No risk of emergency [[cholecystectomy]]
OR
**EC has the following limitations:<ref name="pmid24444271">{{cite journal |vauthors=Ozkardeş AB, Tokaç M, Dumlu EG, Bozkurt B, Ciftçi AB, Yetişir F, Kılıç M |title=Early versus delayed laparoscopic cholecystectomy for acute cholecystitis: a prospective, randomized study |journal=Int Surg |volume=99 |issue=1 |pages=56–61 |year=2014 |pmid=24444271 |pmc=3897343 |doi=10.9738/INTSURG-D-13-00068.1 |url=}}</ref>
 
***Increased intraoperative complications
The feasibility of surgery depends on the stage of [malignancy] at diagnosis.
***Increased postoperative complications
===Lapascopic cholecystectomy===
There are two main types of procedures used for the laparoscopic [[cholecystectomy]] ; Single-incision laparoscopic [[cholecystectomy]] (SILC) and conventional multiport laparoscopic [[cholecystectomy]] (CMLC).<ref name="pmid23557447">{{cite journal |vauthors=Sato N, Yabuki K, Shibao K, Mori Y, Tamura T, Higure A, Yamaguchi K |title=Risk factors for a prolonged operative time in a single-incision laparoscopic cholecystectomy |journal=HPB (Oxford) |volume=16 |issue=2 |pages=177–82 |year=2014 |pmid=23557447 |pmc=3921014 |doi=10.1111/hpb.12100 |url=}}</ref><ref name="pmid20607556">{{cite journal |vauthors=Antoniou SA, Pointner R, Granderath FA |title=Single-incision laparoscopic cholecystectomy: a systematic review |journal=Surg Endosc |volume=25 |issue=2 |pages=367–77 |year=2011 |pmid=20607556 |doi=10.1007/s00464-010-1217-5 |url=}}</ref><ref name="pmid22819642">{{cite journal |vauthors=Leung D, Yetasook AK, Carbray J, Butt Z, Hoeger Y, Denham W, Barrera E, Ujiki MB |title=Single-incision surgery has higher cost with equivalent pain and quality-of-life scores compared with multiple-incision laparoscopic cholecystectomy: a prospective randomized blinded comparison |journal=J. Am. Coll. Surg. |volume=215 |issue=5 |pages=702–8 |year=2012 |pmid=22819642 |doi=10.1016/j.jamcollsurg.2012.05.038 |url=}}</ref><ref name="pmid22767084">{{cite journal |vauthors=Pisanu A, Reccia I, Porceddu G, Uccheddu A |title=Meta-analysis of prospective randomized studies comparing single-incision laparoscopic cholecystectomy (SILC) and conventional multiport laparoscopic cholecystectomy (CMLC) |journal=J. Gastrointest. Surg. |volume=16 |issue=9 |pages=1790–801 |year=2012 |pmid=22767084 |doi=10.1007/s11605-012-1956-9 |url=}}</ref>
*Single-incision [[laparoscopic cholecystectomy]] (SILC)
**As compared to CMLC, SILC has the following features:
***Improved cosmetic results
***Decreased postoperative pain
***Increased operative time
***Increased intraoperative blood loss
*Conventional multiport laparoscopic [[cholecystectomy]] (CMLC)
**As compared to SILC, CMLC has the following features:
***Decreased operative time
***Decreased intraoperative blood loss
====Indications====
*Indications of laparoscopic cholecystitis are:<ref name="pmid9511287">{{cite journal |vauthors=Movchun AA, Koloss OE, Oppel' TA, Abdullaeva UA |title=[Surgical treatment of chronic calculous cholecystitis and its complications] |language=Russian |journal=Khirurgiia (Mosk) |volume= |issue=1 |pages=8–10 |year=1998 |pmid=9511287 |doi= |url=}}</ref><ref name="pmid11432016">{{cite journal |vauthors=Fletcher DR |title=Gallstones. Modern management |journal=Aust Fam Physician |volume=30 |issue=5 |pages=441–5 |year=2001 |pmid=11432016 |doi= |url=}}</ref>
**Cholecystitis (Acute/Chronic)
**Symptomatic cholelithiasis
**Biliary dyskinesia
**Acalculous cholecystitis
**Gallstone pancreatitis
**Gallbladder masses/polyps


OR
====Contraindications====
*Contraindications of laparoscopic cholecystitis are:<ref name="pmid9511287">{{cite journal |vauthors=Movchun AA, Koloss OE, Oppel' TA, Abdullaeva UA |title=[Surgical treatment of chronic calculous cholecystitis and its complications] |language=Russian |journal=Khirurgiia (Mosk) |volume= |issue=1 |pages=8–10 |year=1998 |pmid=9511287 |doi= |url=}}</ref><ref name="pmid11432016">{{cite journal |vauthors=Fletcher DR |title=Gallstones. Modern management |journal=Aust Fam Physician |volume=30 |issue=5 |pages=441–5 |year=2001 |pmid=11432016 |doi= |url=}}</ref>
**Inability to tolerate pneumoperitoneum or general anesthesia
**Uncorrectable coagulopathy
**Metastatic disease


Surgery is the mainstay of treatment for [disease or malignancy].
===Percutaneous cholecystostomy===  
 
Percutaneous cholecystostomy (PC) is an alternative to emergency [[cholecystectomy]] in complicated cases of high-risk patients.<ref name="pmid24679431">{{cite journal |vauthors=Knab LM, Boller AM, Mahvi DM |title=Cholecystitis |journal=Surg. Clin. North Am. |volume=94 |issue=2 |pages=455–70 |year=2014 |pmid=24679431 |doi=10.1016/j.suc.2014.01.005 |url=}}</ref><ref name="pmid28603584">{{cite journal |vauthors=Gomes CA, Junior CS, Di Saverio S, Sartelli M, Kelly MD, Gomes CC, Gomes FC, Corrêa LD, Alves CB, Guimarães SF |title=Acute calculous cholecystitis: Review of current best practices |journal=World J Gastrointest Surg |volume=9 |issue=5 |pages=118–126 |year=2017 |pmid=28603584 |pmc=5442405 |doi=10.4240/wjgs.v9.i5.118 |url=}}</ref><ref name="pmid26580708">{{cite journal |vauthors=Yeo CS, Tay VW, Low JK, Woon WW, Punamiya SJ, Shelat VG |title=Outcomes of percutaneous cholecystostomy and predictors of eventual cholecystectomy |journal=J Hepatobiliary Pancreat Sci |volume=23 |issue=1 |pages=65–73 |year=2016 |pmid=26580708 |doi=10.1002/jhbp.304 |url=}}</ref>
==Indications==
*The results showed that the mortality, morbidity and conversion rate were the same in PC and [[laparoscopic cholecystectomy]].
 
*Older patients with increased comorbidities usually undergo [[cholecystectomy]].
*Surgical intervention is not recommended for the management of [disease name].
*If a patient is not a good surgical candidate at the time of presentation, [[cholecystectomy]] is preferred. Patients usually have [[biliary]] complications and [[cholecystectomy]] is required ultimately.
OR
*Surgery is not the first-line treatment option for patients with [disease name]. Surgery is usually reserved for patients with either:
**[Indication 1]
**[Indication 2]
**[Indication 3]
*The mainstay of treatment for [disease name] is medical therapy. Surgery is usually reserved for patients with either:
**[Indication 1]
**[Indication 2]
**[Indication 3]
 
==Surgery==
*Surgery is the mainstay of treatment for acute cholecystitis.<ref name="pmid1386505">{{cite journal |vauthors=Soper NJ, Stockmann PT, Dunnegan DL, Ashley SW |title=Laparoscopic cholecystectomy. The new 'gold standard'? |journal=Arch Surg |volume=127 |issue=8 |pages=917–21; discussion 921–3 |year=1992 |pmid=1386505 |doi= |url=}}</ref>


==References==
==References==
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Latest revision as of 16:20, 8 January 2018

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Furqan M M. M.B.B.S[2]

Overview

Surgery is the mainstay of treatment for acute cholecystitis (calculous and acalculous).Laparoscopic cholecystectomy is the gold standard for the treatment of acute cholecystitis and is usually preferred over the open cholecystectomy. Percutaneous cholecystostomy (PC) is an alternative to emergency cholecystectomy in complicated cases of high-risk patients.

Surgery

Lapascopic cholecystectomy

There are two main types of procedures used for the laparoscopic cholecystectomy ; Single-incision laparoscopic cholecystectomy (SILC) and conventional multiport laparoscopic cholecystectomy (CMLC).[12][13][14][15]

  • Single-incision laparoscopic cholecystectomy (SILC)
    • As compared to CMLC, SILC has the following features:
      • Improved cosmetic results
      • Decreased postoperative pain
      • Increased operative time
      • Increased intraoperative blood loss
  • Conventional multiport laparoscopic cholecystectomy (CMLC)
    • As compared to SILC, CMLC has the following features:
      • Decreased operative time
      • Decreased intraoperative blood loss

Indications

  • Indications of laparoscopic cholecystitis are:[16][17]
    • Cholecystitis (Acute/Chronic)
    • Symptomatic cholelithiasis
    • Biliary dyskinesia
    • Acalculous cholecystitis
    • Gallstone pancreatitis
    • Gallbladder masses/polyps

Contraindications

  • Contraindications of laparoscopic cholecystitis are:[16][17]
    • Inability to tolerate pneumoperitoneum or general anesthesia
    • Uncorrectable coagulopathy
    • Metastatic disease

Percutaneous cholecystostomy

Percutaneous cholecystostomy (PC) is an alternative to emergency cholecystectomy in complicated cases of high-risk patients.[1][18][19]

References

  1. ↑ 1.0 1.1 Knab LM, Boller AM, Mahvi DM (2014). "Cholecystitis". Surg. Clin. North Am. 94 (2): 455–70. doi:10.1016/j.suc.2014.01.005. PMID 24679431.
  2. ↑ Soper NJ, Stockmann PT, Dunnegan DL, Ashley SW (1992). "Laparoscopic cholecystectomy. The new 'gold standard'?". Arch Surg. 127 (8): 917–21, discussion 921–3. PMID 1386505.
  3. ↑ Foard DE, Haber AH (1970). "Physiologically normal senescence in seedlings grown without cell division after massive gamma-irradiation of seeds". Radiat. Res. 42 (2): 372–80. PMID 5442405.
  4. ↑ Koti RS, Davidson CJ, Davidson BR (2015). "Surgical management of acute cholecystitis". Langenbecks Arch Surg. 400 (4): 403–19. doi:10.1007/s00423-015-1306-y. PMID 25971374.
  5. ↑ Bagla P, Sarria JC, Riall TS (2016). "Management of acute cholecystitis". Curr. Opin. Infect. Dis. 29 (5): 508–13. doi:10.1097/QCO.0000000000000297. PMID 27429137.
  6. ↑ Lo CM, Liu CL, Fan ST, Lai EC, Wong J (1998). "Prospective randomized study of early versus delayed laparoscopic cholecystectomy for acute cholecystitis". Ann. Surg. 227 (4): 461–7. PMC 1191296. PMID 9563529.
  7. ↑ Johansson M, Thune A, Blomqvist A, Nelvin L, Lundell L (2003). "Management of acute cholecystitis in the laparoscopic era: results of a prospective, randomized clinical trial". J. Gastrointest. Surg. 7 (5): 642–5. PMID 12850677.
  8. ↑ Lai PB, Kwong KH, Leung KL, Kwok SP, Chan AC, Chung SC, Lau WY (1998). "Randomized trial of early versus delayed laparoscopic cholecystectomy for acute cholecystitis". Br J Surg. 85 (6): 764–7. doi:10.1046/j.1365-2168.1998.00708.x. PMID 9667702.
  9. ↑ Kolla SB, Aggarwal S, Kumar A, Kumar R, Chumber S, Parshad R, Seenu V (2004). "Early versus delayed laparoscopic cholecystectomy for acute cholecystitis: a prospective randomized trial". Surg Endosc. 18 (9): 1323–7. doi:10.1007/s00464-003-9230-6. PMID 15803229.
  10. ↑ 10.0 10.1 10.2 Ozkardeş AB, Tokaç M, Dumlu EG, Bozkurt B, Ciftçi AB, Yetişir F, Kılıç M (2014). "Early versus delayed laparoscopic cholecystectomy for acute cholecystitis: a prospective, randomized study". Int Surg. 99 (1): 56–61. doi:10.9738/INTSURG-D-13-00068.1. PMC 3897343. PMID 24444271.
  11. ↑ Cao AM, Eslick GD, Cox MR (2015). "Early Cholecystectomy Is Superior to Delayed Cholecystectomy for Acute Cholecystitis: a Meta-analysis". J. Gastrointest. Surg. 19 (5): 848–57. doi:10.1007/s11605-015-2747-x. PMID 25749854.
  12. ↑ Sato N, Yabuki K, Shibao K, Mori Y, Tamura T, Higure A, Yamaguchi K (2014). "Risk factors for a prolonged operative time in a single-incision laparoscopic cholecystectomy". HPB (Oxford). 16 (2): 177–82. doi:10.1111/hpb.12100. PMC 3921014. PMID 23557447.
  13. ↑ Antoniou SA, Pointner R, Granderath FA (2011). "Single-incision laparoscopic cholecystectomy: a systematic review". Surg Endosc. 25 (2): 367–77. doi:10.1007/s00464-010-1217-5. PMID 20607556.
  14. ↑ Leung D, Yetasook AK, Carbray J, Butt Z, Hoeger Y, Denham W, Barrera E, Ujiki MB (2012). "Single-incision surgery has higher cost with equivalent pain and quality-of-life scores compared with multiple-incision laparoscopic cholecystectomy: a prospective randomized blinded comparison". J. Am. Coll. Surg. 215 (5): 702–8. doi:10.1016/j.jamcollsurg.2012.05.038. PMID 22819642.
  15. ↑ Pisanu A, Reccia I, Porceddu G, Uccheddu A (2012). "Meta-analysis of prospective randomized studies comparing single-incision laparoscopic cholecystectomy (SILC) and conventional multiport laparoscopic cholecystectomy (CMLC)". J. Gastrointest. Surg. 16 (9): 1790–801. doi:10.1007/s11605-012-1956-9. PMID 22767084.
  16. ↑ 16.0 16.1 Movchun AA, Koloss OE, Oppel' TA, Abdullaeva UA (1998). "[Surgical treatment of chronic calculous cholecystitis and its complications]". Khirurgiia (Mosk) (in Russian) (1): 8–10. PMID 9511287.
  17. ↑ 17.0 17.1 Fletcher DR (2001). "Gallstones. Modern management". Aust Fam Physician. 30 (5): 441–5. PMID 11432016.
  18. ↑ Gomes CA, Junior CS, Di Saverio S, Sartelli M, Kelly MD, Gomes CC, Gomes FC, Corrêa LD, Alves CB, Guimarães SF (2017). "Acute calculous cholecystitis: Review of current best practices". World J Gastrointest Surg. 9 (5): 118–126. doi:10.4240/wjgs.v9.i5.118. PMC 5442405. PMID 28603584.
  19. ↑ Yeo CS, Tay VW, Low JK, Woon WW, Punamiya SJ, Shelat VG (2016). "Outcomes of percutaneous cholecystostomy and predictors of eventual cholecystectomy". J Hepatobiliary Pancreat Sci. 23 (1): 65–73. doi:10.1002/jhbp.304. PMID 26580708.

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