Abstract
Purpose
To compare the safety of emergent laparoscopic cholecystectomy for acute acalculous cholecystitis (AAC) with surgery for acute calculous cholecystitis (ACC).
Methods
We retrospectively reviewed the perioperative records of 111 patients who underwent emergent laparoscopic cholecystectomy for acute cholecystitis under the care of the Department of Digestive Surgery, Kawasaki Medical School, Kurashiki, between January 2010 and April 2014. Patients were divided into the AAC group (27 patients) and the ACC group (84 patients), and their perioperative outcomes were compared.
Results
Patients in the AAC group had significantly higher disease severity and American Society of Anesthesiologists physical status scores (p = 0.001 and 0.037, respectively), lower blood hemoglobin and albumin concentrations (p = 0.0005 and 0.017, respectively), and lower hematocrit and platelet count (p < 0.0001 and 0.040, respectively) than those in the ACC group. When we compared perioperative outcomes, we also found that patients in the AAC group were more likely to have received a blood transfusion (p = 0.002) and to have required conversion to open surgery (p = 0.008). There were no significant differences in morbidity, mortality or length of hospital stay.
Conclusions
Early laparoscopic cholecystectomy is safe in acute acalculous as well as acute calculous cholecystitis.
Similar content being viewed by others
References
Takada T, Strasberg SM, Solomkin JS, Pitt HA, Gomi H, Yoshida M, Tokyo Guidelines Revision Committee, et al. TG13: updated Tokyo Guidelines for the management of acute cholangitis and cholecystitis. J Hepatobiliary Pancreat Sci. 2013;20:1–7.
Huffman JL, Schenker S. Acute acalculous cholecystitis: a review. Clin Gastroenterol Hepatol. 2010;8:15–22.
Yajima Hiroshi, Kanai Hideki, Son Kyonsu, Yoshida Kazuhiko, Yanaga Katsuhiko. Reasons and risk factors for intraoperative conversion from laparoscopic to open cholecystectomy. Surg Today. 2014;44:80–3.
Asai Koji, Watanabe Manabu, Kusachi Shinya, Matsukiyo Hiroshi, Saito Tomoaki, Kodama Hajime, et al. Risk factors for conversion of laparoscopic cholecystectomy to open surgery associated with the severity characteristics according to the Tokyo guidelines. Surg Today. 2014;44:2300–4.
Wang AJ, Wang TE, Lin CC, Lin SC, Shih SC. Clinical predictors of severe gallbladder complications in acute acalculous cholecystitis. World J Gastroenterol. 2003;9:2821–3.
Ryu JK, Ryu KH, Kim KH. Clinical features of acute acalculous cholecystitis. J Clin Gastroenterol. 2003;36:166–9.
Ross DC, Lee KC, Peters WJ, Douglas LG. Acalculous cholecystitis in association with major burns. Burns Incl Therm Inj. 1987;13:488–91.
McDermott MW, Scudamore CH, Boileau LO, Snelling CF, Kramer TA. Acalculous cholecystitis: its role as a complication of major burn injury. Can J Surg. 1985;28:529–33.
Munster AM, Goodwin MN, Pruitt BA Jr. Acalculous cholecystitis in burned patients. Am J Surg. 1971;122:591–3.
Laurila J, Syrjala H, Laurila PA, Saarnio J, Ala-Kokko TI. Acute acalculous cholecystitis in critically ill patients. Acta Anaesthesiol Scand. 2004;48:986–91.
Theodorou P, Maurer CA, Spanholtz TA, Phan TQ, Amini P, Perbix W, et al. Acalculous cholecystitis in severely burned patients: incidence and predisposing factors. Burns. 2009;35:405–11.
Barie PS, Eachempati SR. Acute acalculous cholecystitis. Curr Gastroenterol Rep. 2003;5:302–9.
Matsusaki S, Maguchi H, Takahashi K, Katanuma A, Osanai M, Urata T, et al. Clinical features of acute acalculous cholecystitis—nosocomial manner and community-acquired manner. Nihon Shokakibyo Gakkai Zasshi (Jpn J Gastroenterol). 2008;105:1749–57.
Sosna J, Copel L, Kane RA, Kruskal JB. Ultrasound-guided percutaneous cholecystostomy: update on technique and clinical applications. Surg Technol Int. 2003;11:135–9.
Owen CC, Bilhartz LE. Gallbladder polyps, cholesterolosis, adenomyomatosis, and acute acalculous cholecystitis. Semin Gastrointest Dis. 2003;14:178–88.
Chandler CF, Lane JS, Ferguson P, Thompson JE, Ashley SW. Prospective evaluation of early versus delayed laparoscopic cholecystectomy for treatment of acute cholecystitis. Am Surg. 2000;66:896–900.
Lai PB, Kwong KH, Leung KL, Kwok SP, Chan AC, Chung SC, et al. Randomized trial of early versus delayed laparoscopic cholecystectomy for acute cholecystitis. Br J Surg. 1998;85:764–7.
Lo CM, Liu CL, Fan ST, Lai EC, Wong J. Prospective randomized study of early versus delayed laparoscopic cholecystectomy for acute cholecystitis. Ann Surg. 1998;227:461–7.
Kolla SB, Aggarwal S, Kumar A, Kumar R, Chumber S, Parshad R, et al. Early versus delayed laparoscopic cholecystectomy for acute cholecystitis: a prospective randomized trial. Surg Endosc. 2004;18:1323–7.
Johansson M, Thune A, Blomqvist A, Nelvin L, Lundell L. Impact of choice of therapeutic strategy for acute cholecystitis on patient’s health-related quality of life: results of a randomized, controlled clinical trial. Dig Surg. 2004;21:359–62.
Serralta AS, Bueno JL, Planells MR, Rodero DR. Prospective evaluation of emergency versus delayed laparoscopic cholecystectomy for early cholecystitis. Surg Laparosc Endosc Percutan Tech. 2003;13:71–5.
Conflict of interest
The authors have no conflicts of interest or financial ties to disclose.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Ueno, D., Nakashima, H., Higashida, M. et al. Emergent laparoscopic cholecystectomy for acute acalculous cholecystitis revisited. Surg Today 46, 309–312 (2016). https://doi.org/10.1007/s00595-015-1173-8
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00595-015-1173-8