Staff Members - Benha University
Complicated acute cholecystitis; protocol of management
Kasr Eleiny Journal of Surgery • 2017
Publication Information
Authors
Mokhtar Abd Elrahman Bahbah, Ehab M Oraby,
Keywords
Acute cholecystitis, Laparoscopic cholecystectomy, percutaneous cholecystostomy, Mortality rate
Journal
Kasr Eleiny Journal of Surgery
Publisher
Not Available
Volume
Not Available
Issue
Not Available
Pages
Not Available
publication.type
International
Paper Link
Not Available
Supplementary Materials
Not Available
Abstract
Objectives: To evaluate the outcome of management plan for acute cholecystitis (AC) patients according to patients' general condition and disease severity.
Patients & Methods: advanced cases of acute cholecystitis (grades II-III) were evaluated for fitness for general anesthesia (GA) according to criteria of American Society of Anesthesiologists and fit patients underwent laparoscopic cholecystectomy (LC), while unfit patients underwent percutaneous cholecystostomy (PC).
Results: Eighteen fit patients underwent LC; two patients (11.1%) required open conversion. 13 patients developed PO morbidities, but only two complications were surgery-related. Only one patient died secondary to surgery-related cause (MR of 5.6%). Eight patients underwent PC; 6 patients developed PO morbidities and one patient died during hospital stay due to surgery related cause (MR of 12.5%). Patients had PC or LC showed non-significant difference as regards time till 1st ambulation or oral intake and for ICU stay, but PC patients required significantly longer hospital stay (12.6 vs. 14.6 days).
Conclusion: LC is effective definitive therapy if patient was fit for GA. For patients who are unfit for GA, PC is a feasible, safe and effective option with acceptable outcomes.
Patients & Methods: advanced cases of acute cholecystitis (grades II-III) were evaluated for fitness for general anesthesia (GA) according to criteria of American Society of Anesthesiologists and fit patients underwent laparoscopic cholecystectomy (LC), while unfit patients underwent percutaneous cholecystostomy (PC).
Results: Eighteen fit patients underwent LC; two patients (11.1%) required open conversion. 13 patients developed PO morbidities, but only two complications were surgery-related. Only one patient died secondary to surgery-related cause (MR of 5.6%). Eight patients underwent PC; 6 patients developed PO morbidities and one patient died during hospital stay due to surgery related cause (MR of 12.5%). Patients had PC or LC showed non-significant difference as regards time till 1st ambulation or oral intake and for ICU stay, but PC patients required significantly longer hospital stay (12.6 vs. 14.6 days).
Conclusion: LC is effective definitive therapy if patient was fit for GA. For patients who are unfit for GA, PC is a feasible, safe and effective option with acceptable outcomes.