Optimal Timing of Laparoscopic Cholecystectomy After Conservative Therapy for Acute Cholecystitis.

Autor:	Enami Y; Digestive Disease Center, Showa University Northern Yokohama Hospital, Yokohama, Japan.; Department of Gastrointestinal and General Surgery, Showa University, School of Medicine, Tokyo, Japan., Aoki T; Department of Gastrointestinal and General Surgery, Showa University, School of Medicine, Tokyo, Japan., Tomioka K; Digestive Disease Center, Showa University Northern Yokohama Hospital, Yokohama, Japan.; Department of Gastrointestinal and General Surgery, Showa University, School of Medicine, Tokyo, Japan., Hirai T; Digestive Disease Center, Showa University Northern Yokohama Hospital, Yokohama, Japan.; Department of Gastrointestinal and General Surgery, Showa University, School of Medicine, Tokyo, Japan., Shibata H; Digestive Disease Center, Showa University Northern Yokohama Hospital, Yokohama, Japan.; Department of Gastrointestinal and General Surgery, Showa University, School of Medicine, Tokyo, Japan., Saito K; Digestive Disease Center, Showa University Northern Yokohama Hospital, Yokohama, Japan.; Department of Gastrointestinal and General Surgery, Showa University, School of Medicine, Tokyo, Japan., Nagaishi S; Digestive Disease Center, Showa University Northern Yokohama Hospital, Yokohama, Japan.; Department of Gastrointestinal and General Surgery, Showa University, School of Medicine, Tokyo, Japan., Takano Y; Digestive Disease Center, Showa University Northern Yokohama Hospital, Yokohama, Japan., Seki J; Digestive Disease Center, Showa University Northern Yokohama Hospital, Yokohama, Japan., Shimada S; Digestive Disease Center, Showa University Northern Yokohama Hospital, Yokohama, Japan., Nakahara K; Digestive Disease Center, Showa University Northern Yokohama Hospital, Yokohama, Japan., Takehara Y; Digestive Disease Center, Showa University Northern Yokohama Hospital, Yokohama, Japan., Mukai S; Digestive Disease Center, Showa University Northern Yokohama Hospital, Yokohama, Japan., Sawada N; Digestive Disease Center, Showa University Northern Yokohama Hospital, Yokohama, Japan., Ishida F; Digestive Disease Center, Showa University Northern Yokohama Hospital, Yokohama, Japan., Kudo SE; Digestive Disease Center, Showa University Northern Yokohama Hospital, Yokohama, Japan.
Jazyk:	angličtina
Zdroj:	Cancer diagnosis & prognosis [Cancer Diagn Progn] 2023 Sep 03; Vol. 3 (5), pp. 571-576. Date of Electronic Publication: 2023 Sep 03 (Print Publication: 2023).
DOI:	10.21873/cdp.10256
Abstrakt:	Background/aim: According to the Tokyo Guidelines 2018, the operation for acute cholecystitis is recommended to be performed as early as possible. However, there are cases in which early surgeries cannot be performed due to complications of patients or facility conditions, resulting in elective surgery. Hence, we retrospectively analyzed elective surgery cases in this study. Patients and Methods: There were 345 patients who were underwent laparoscopic cholecystectomy (LC) at our hospital from January 2019 to December 2020 in this retrospective study. A total of 83 patients underwent LC more than 3 days after conservative treatment. The elective LC patients were divided into the Early group (4-90 days after onset, n=36) and the Delayed group [91 days or more (13 weeks or more) after onset, n=31], excluding 16 patients who underwent percutaneous transhepatic gallbladder drainage. Results: As for operative time, there was a significant difference between the Delayed and Early groups (91.2 vs. 117 minutes, p=0.0108). And also, there was a significant difference in the postoperative hospital stay, which was significantly shorter in the Delayed group than in the Early group (3.4 vs. 5.9 days, p=0.0436). Although there were no significant differences in either conversion rates or complication rates, both of these were decreasing in the Delayed group. In particular, there were no complications in the Delayed group. Conclusion: When the conservative treatment for acute cholecystitis precedes and precludes urgent/early LC within 3 days, delaying LC for at least 91 days (13 weeks or more) after onset could reduce operative time and postoperative hospital stay. Moreover, there would be no complications after LC, and the rates of conversion during LC may be kept low. Competing Interests: All Authors have no conflicts of interest to declare in relation to this study. (Copyright 2023, International Institute of Anticancer Research.)
Databáze:	MEDLINE
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