Akut Kolesistit için Tedavi Stratejileri: Cerrahi Zamanlamasının Bir Önemi Var Mıdır?


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Ekinci Ö., Eren T. T. , Gapbarov A., Beyazadam D., Bulut N. , Leblebici İ. M. , ...More

Medical Journal of Bakirkoy, vol.17, no.4, pp.312-319, 2021 (Journal Indexed in ESCI)

  • Publication Type: Article / Article
  • Volume: 17 Issue: 4
  • Publication Date: 2021
  • Doi Number: 10.4274/bmj.galenos.2021.03411
  • Title of Journal : Medical Journal of Bakirkoy
  • Page Numbers: pp.312-319

Abstract

Objective: The timing of cholecystectomy is still controversial in acute cholecystitis (AC). This study aimed to evaluate the outcomes of early cholecystectomy (EC), delayed cholecystectomy (DC), and non-operative management (NOM) for AC.


Methods: The patients with AC, who were treated in a one-year-period, were divided into EC, DC, and NOM subgroups. Parameters, including demographics, laboratory results, imaging findings, body mass index (BMI), American Society of Anesthesiologists (ASA) score, the timing of surgery, operative time, gallstone size, postoperative complications, and postoperative length of hospital stay were analyzed.


Results: The study group of 125 patients comprised of 71 patients (56.8%) in the EC, 29 (23.2%) in the DC, and 25 patients (20%) in the NOM group. Patients in the NOM group were relatively older (p<0.05). BMI values and physical examination findings were similar among the subgroups (p>0.05). The incidence of ASA score of 3 and the mean levels of bilirubin, aspartate aminotransferase, and alanine aminotransferase was higher, whereas the mean hemoglobin value was lower in the NOM group (p<0.05). Gallstones smaller than 1 cm were more common in the DC group (p<0.05). The mean operative times, conversion rates, and postoperative complications were similar between the EC and DC groups (p>0.05). The length of hospital stay was shorter in the DC group (p<0.05).


Conclusion: The surgical treatment of hospitalized patients with AC can be performed anytime within the first week of their admissions unless the clinical and laboratory findings render the patient unfit for surgery.