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Gall Bladder Empyema: Early Cholecystectomy during the Index Admission Improves Outcomes.
| Content Provider | Europe PMC |
|---|---|
| Author | El Zanati, Hisham Nassar, Ahmad H. M. Zino, Samer Katbeh, Tarek Ng, Hwei Jene Abdellatif, Ayman |
| Copyright Year | 2020 |
| Abstract | Objectives:We aim to evaluate our policy of index admission management of gall bladder empyema and the effect of the timing of surgery on the outcomes.Methods:We analyzed a series of 5400 laparoscopic cholecystectomies. Data were collected prospectively over 26 y. Patients were divided into two groups: group 1, intervention within 72 h, and group 2, intervention after 72 h of admission. We had a policy of intention to treat during the index admission, but delays sometimes occurred because of late referral, a need to optimize patients, availability of theater time, or the biliary surgeon being on leave. The groups were then compared with regard to the duration of surgery, the difficulty grading, complications, hospital stay, and conversion rate.Results:A total of 372 patients were included; 160 (43%) operated on within 72 h (group 1) and 212 (57%) after 72 h (group 2). There was no statistically significant difference between the two groups with regard to the operation time, conversion rate, and complications rate. The difference in total hospital stay was, however, statistically significant.Conclusion:Surgical management of empyema should be offered as soon as possible after admission as with any acute cholecystitis. Surgery carried out after 72 h of admission is only associated with longer hospital stay but no statistically significant differences in other outcome parameters. In the presence of specialist expertise, fitness for surgery should be the determining factor of whether or not to offer surgery to these patients, regardless of the interval since their admission. |
| Related Links | https://europepmc.org/backend/ptpmcrender.fcgi?accid=PMC7208918&blobtype=pdf |
| ISSN | 10868089 |
| Journal | JSLS : Journal of the Society of Laparoscopic & Robotic Surgeons [JSLS] |
| Volume Number | 24 |
| PubMed Central reference number | PMC7208918 |
| Issue Number | 2 |
| PubMed reference number | 32425482 |
| e-ISSN | 19383797 |
| DOI | 10.4293/jsls.2020.00015 |
| Language | English |
| Publisher | Society of Laparoendoscopic Surgeons |
| Publisher Date | 2020-04-01 |
| Publisher Place | Miami, FL |
| Access Restriction | Open |
| Rights License | This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial No Derivatives License (http://creativecommons.org/licenses/by-nc-nd/3.0/us/), which permits for noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited and is not altered in any way. © 2020 by JSLS, Journal of the Society of Laparoscopic & Robotic Surgeons. |
| Subject Keyword | gallbladder empyema laparoscopic cholecystectomy difficulty grading Nassar scale intraopertative cholangiography |
| Content Type | Text |
| Resource Type | Article |
| Subject | Surgery |
