Is cholecystectomy the treatment of choice for acute acalculous cholecystitis?: a systematic review of the literature
| Autor: | José Luis Aguayo Albasini, Milagros Carrasco Prats, Lorena Galindo Iñíguez, Diego Flores Funes, Víctor Soria Aledo |
|---|---|
| Jazyk: | angličtina |
| Předmět: |
medicine.medical_specialty
Elective cholecystectomy Definitive Therapy medicine.medical_treatment Perforation (oil well) Cochrane Library 03 medical and health sciences 0302 clinical medicine medicine Humans In patient Cholecystectomy lcsh:RC799-869 Percutaneous cholecystostomy Gynecology Acalculous Cholecystitis business.industry Acute acalculous cholecystitis Gastroenterology General Medicine Surgical risk 030220 oncology & carcinogenesis Systematic review 030211 gastroenterology & hepatology lcsh:Diseases of the digestive system. Gastroenterology business |
| Zdroj: | Revista Espanola de Enfermedades Digestivas, Vol 109, Iss 10, Pp 708-718 Revista Española de Enfermedades Digestivas v.109 n.10 2017 SciELO España. Revistas Científicas Españolas de Ciencias de la Salud instname |
| ISSN: | 1130-0108 |
| Popis: | espanolIntroduccion y objetivos: actualmente no existe consenso entre colecistectomia o colecistostomia percutanea como eleccion terapeutica en la colecistitis aguda alitiasica. El objetivo de nuestro trabajo es revisar la evidencia cientifica acerca del tratamiento en estos pacientes segun los hallazgos clinicos y radiologicos. Metodos: revision sistematica de la literatura desde 2000 hasta 2016. La busqueda se realizo usando PubMed, Indice Medico Espanol, Cochrane Library y Embase, siguiendo nuestros criterios de inclusion: idioma de publicacion (ingles o espanol), pacientes adultos, etiologia alitiasica y apropiado diseno de estudio. Resultados: se han identificado 1.013 articulos; finalmente, se han seleccionado para la revision diez articulos que describian los resultados de pacientes tratados con colecistostomia percutanea y colecistectomia urgente, incluyendo cinco estudios observacionales controlados y cinco series de casos. No se han identificado estudios prospectivos o randomizados con los criterios de busqueda. Los datos de la literatura y el examen de los resultados indicaron que, para la colecistitis aguda alitiasica, la colecistostomia percutanea puede ser un tratamiento definitivo sin requerir una colecistectomia electiva posterior. Conclusiones: la colecistostomia percutanea puede ser la primera opcion de tratamiento en pacientes con colecistitis aguda alitiasica salvo en los casos que presenten perforacion o gangrena vesicular. Los pacientes con bajo riesgo quirurgico podrian beneficiarse de una colecistectomia, aunque ambas opciones de tratamiento pueden ser efectivas. La colecistostomia percutanea en pacientes con colecistitis aguda alitiasica puede ser un tratamiento definitivo sin necesidad de una colecistectomia electiva posterior. No obstante, la calidad de los estudios es, en general, baja y hace necesario tomar con cautela las recomendaciones finales EnglishBackground and objectives: There is currently no consensus with regard to the use of cholecystectomy or percutaneous cholecystostomy as the therapy of choice for acute acalculous cholecystitis. The goal of this study was to review the scientific evidence on the management of these patients according to clinical and radiographic findings. Methods: A systematic review of the literature from 2000 to 2016 was performed. The databases of PubMed, Indice Medico Espanol, Cochrane Library and Embase were searched according to the following inclusion criteria: publication language (English or Spanish), adult patients, acalculous etiology and appropriate study design. Results: A total of 1,013 articles were identified and ten articles were selected for review. These included five observational controlled studies and five case series which described the outcome of patients treated with percutaneous cholecystostomy and emergency cholecystectomy. No prospective or randomized studies were identified using the search criteria. The data from the literature and analysis of results suggested that percutaneous cholecystostomy may be a definitive therapy for acute acalculous cholecystitis with no need for subsequent elective cholecystectomy. Conclusions: Percutaneous cholecystostomy may be the first treatment option for patients with acute acalculous cholecystitis except in cases with a perforation or gallbladder gangrene. Patients at low surgical risk may benefit from cholecystectomy but both treatment options may be effective. Percutaneous cholecystostomy in patients with acute acalculous cholecystitis may be a definitive therapy with no need for a subsequent elective cholecystectomy. However, the overall quality of studies is low and the final recommendations should be considered with caution. |
| Databáze: | OpenAIRE |
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