Sert İsmail, İpekci Fuat, Engin Ömer, Karaoğlan Muharrem, Çetindağ Özhan
Clinic of General Surgery and Transplantation, Tepecik Training and Research Hospital, İzmir, Turkey.
Clinic of General Surgery, Tepecik Training and Research Hospital, İzmir, Turkey.
Turk J Surg. 2017 Jun 1;33(2):80-86. doi: 10.5152/UCD.2016.3305. eCollection 2017.
The timing of early cholecystectomy in acute cholecystitis is still controversial, and data regarding the use of Tokyo 2013 guideline for diagnosis and severity grading in Acute Cholecystitis is limited. The aim of this study was to evaluate the clinical and pathologic outcomes of early cholecystectomy after 72 hr and within seven days of index admission according to Tokyo 2013 guideline for diagnosis and severity grading of Acute cholecystitis (in patients with Acute cholecystitis.
Medical charts of 172 patients who underwent early cholecystectomy after 72 hr and within 7 days of index admission with a diagnosis of Acute cholecystitis between Aug 2009 and Apr 2014 were retrospectively analyzed. Patients were classified according Tokyo 2013 guideline criteria.
The median age of the study group was 52 yr. The rates of open and laparoscopic cholecystectomies was 53.5% and 33.1%, respectively. Conversion to open cholecystectomy was performed in 19 patients (13.4 %). The median length of hospital stay was 7 days. Eighty-four patients (59.2%) met the criteria for a definite diagnosis of Acute cholecystitis according to Tokyo 2013 guideline. Longer postoperative and total length of hospital stay was determined in patients with a definite diagnosis.
Increased severity grading is correlated with longer pre- and post-operative hospital stay. Early cholecystectomy in Acute cholecystitis performed by experienced surgeons after 72 hr of admission and within 7 days maybe a feasible and safe procedure.
急性胆囊炎早期胆囊切除术的时机仍存在争议,关于使用《东京2013年急性胆囊炎诊断和严重程度分级指南》的数据有限。本研究的目的是根据《东京2013年急性胆囊炎诊断和严重程度分级指南》,评估在入院72小时后和7天内进行早期胆囊切除术的临床和病理结果(针对急性胆囊炎患者)。
回顾性分析了2009年8月至2014年4月期间172例在入院72小时后和7天内诊断为急性胆囊炎并接受早期胆囊切除术患者的病历。根据《东京2013年指南》标准对患者进行分类。
研究组的中位年龄为52岁。开腹胆囊切除术和腹腔镜胆囊切除术的比例分别为53.5%和33.1%。19例患者(13.4%)转为开腹胆囊切除术。中位住院时间为7天。根据《东京2013年指南》,84例患者(59.2%)符合急性胆囊炎明确诊断标准。明确诊断的患者术后住院时间和总住院时间更长。
严重程度分级增加与术前和术后住院时间延长相关。由经验丰富的外科医生在入院72小时后和7天内对急性胆囊炎进行早期胆囊切除术可能是一种可行且安全的手术。