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ORIGINAL RESEARCH article
Front. Surg.
Sec. Visceral Surgery
Volume 11 - 2024 |
doi: 10.3389/fsurg.2024.1452175
Evaluating surgical outcomes and their predictive factors in acute, early cholecystectomies: 13-year experience from a tertiary care center
Provisionally accepted
Illés Tóth
1
Ria Benko
2
Mária Matuz
2*
Dániel Váczi
1*
András Négyessy
1*
Emil Terhes
1*
Andrási László
1*
Janos Tajti
1
József Pieler
1*
László Libor
1
György Lázár
1*
Szabolcs Ábrahám
1*- 1 Department of Surgery, University of Szeged, Szeged, Hungary
- 2 Department of Clinical Pharmacology, University of Szeged, Szeged, Hungary
Introduction: This study aimed to identify the predictors of surgical outcomes in acute cholecystitis (AC).Methods: Patients undergoing cholecystectomy for AC between 1 January 2007 and 31 December 2019 at a single center were retrospectively reviewed. Conversion rate (CR), laparoscopic success rate (LSR), mortality, and bile duct injury (BDI) were evaluated in light of sex, age, ultrasound morphological diagnoses, severity of cholecystitis, performance status, time frame, and introduction of percutaneous transhepatic gallbladder drainage (PTGBD).Results: A total of 465 patients underwent early cholecystectomy. CR and LSR were 16.89% and 78.28%, respectively; the mortality rate was 1.62%. Increased severity of cholecystitis (grade I vs II vs III) was associated with increased mortality (1.17 vs 2.27 vs 8.33%, p = 0.183) and CR (7.09 vs 32.93 vs 28.57%, p < 0.001) and decreased LSR (91.11 vs 61.11 vs 38.46%, p < 0.001). Surgery within 72 hours had lower mortality (1.41 vs 2.6%, p = 0.613) with significantly lower CR (14.45 vs 25.71%, p = 0.008) and higher LSR (81.69 vs 67.53%, p = 0.008) compared to surgery after 72 hours. Mortality (0 vs 0.92 vs 6.19%, p = 0.001) and CR (4.2 vs 16.27 vs 39.53%, p < 0.001) increased with an increase in Charlson Comorbidity index (CCI), while LSR decreased (95.8 vs 79.91 vs 50.49%, p < 0.001).CCI and the severity of cholecystitis had the strongest influence on CR and LSR.Cholecystectomies performed within 72 hours were associated with reduced CR and increased LSR. PTGBD is a viable treatment option in elderly high-risk patients.
Keywords: acute cholecystitis, Early cholecystectomy, laparoscopic cholecystectomy, Conversion rate, Percutaneous transhepatic gallbladder drainage
Received: 20 Jun 2024; Accepted: 24 Dec 2024.
Copyright: © 2024 Tóth, Benko, Matuz, Váczi, Négyessy, Terhes, László, Tajti, Pieler, Libor, Lázár and Ábrahám. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Mária Matuz, Department of Clinical Pharmacology, University of Szeged, Szeged, Hungary
Dániel Váczi, Department of Surgery, University of Szeged, Szeged, Hungary
András Négyessy, Department of Surgery, University of Szeged, Szeged, Hungary
Emil Terhes, Department of Surgery, University of Szeged, Szeged, Hungary
Andrási László, Department of Surgery, University of Szeged, Szeged, Hungary
József Pieler, Department of Surgery, University of Szeged, Szeged, Hungary
György Lázár, Department of Surgery, University of Szeged, Szeged, Hungary
Szabolcs Ábrahám, Department of Surgery, University of Szeged, Szeged, Hungary
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