Authors: Maxime Polo Antoine Duclos Stéphanie Polazzi Cécile Payet Jean Christophe Lifante Eddy Cotte Xavier Barth Olivier Glehen Guillaume Passot
Publish Date: 2015/08/12
Volume: 19, Issue: 11, Pages: 2003-2010
Abstract
The recommended treatment for acute calculous cholecystitis combines antibiotics and cholecystectomy To reduce morbidity and mortality guidelines recommend early cholecystectomy However the optimal timing for surgery on first admission remains controversial This study aims to determine the best timing for cholecystectomy in patients presenting with acute calculous cholecystitisThe French national healthcare database was analyzed to identify all patients undergoing cholecystectomy for acute cholecystitis during the same hospital stay between January 2010 and December 2013 Data regarding patients procedures and hospitals characteristics were collected The relationship between surgery’s timing and clinical outcome was evaluated by multiple logistic regressionsOverall 42452 patients from 507 hospitals were included in the study Postoperative complications requiring invasive treatment occurred in 961 patients 23 and the mortality rate was 11 Adverse postoperative outcomes—intensive care admission reoperation and postoperative sepsis—were significantly lower when surgery was performed between days 1 and 3 3–33 05–06 and 38–41 respectively when compared to surgery performed on the day of admission 56 12 and 52 p 0001 or from day 5 onward 45 1 and 65 respectively p 0001 Mortality was also significantly lower in patients undergoing cholecystectomy between days 1 and 3 after admission 08–1 when compared to patients operated on the day of admission or after day 3 14 on day 0 12 on day 4 and 19 from day 5 all p 0001The authors greatly acknowledge Sophie Polo and Peter Lundberg for their participation in the manuscript edition The authors report no conflict of interest sources of funding for research and publication or previous presentation or publication of this material
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