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Published on: January 31, 2025
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Evaluating Surgical Outcomes in Acute Cholecystectomies
Illés Tóth1, Ria Benkő2, Mária Matuz2
1Department of Surgery, University of Szeged, Szeged, Hungary. (Drs. Tóth, Váczi, Andrási, Libor, Tajti Jr., Lázár, and Ábrahám).
Summary
Predictors of surgical outcomes in acute cholecystitis (AC) were identified. Severity of AC and patient comorbidities significantly impact conversion rates and laparoscopic success, with early surgery improving outcomes.
Area of Science:
- Gastroenterology
- Surgical Outcomes
- Epidemiology
Background:
- Acute cholecystitis (AC) is a common surgical emergency.
- Predicting surgical outcomes is crucial for patient management.
- Factors influencing outcomes in AC surgery require further investigation.
Purpose of the Study:
- To identify predictors of surgical outcomes in patients with acute cholecystitis.
- To analyze the impact of disease severity and patient comorbidities on surgical results.
- To evaluate the influence of surgical timing and interventional procedures on outcomes.
Main Methods:
- Retrospective review of 465 patients undergoing cholecystectomy for AC.
- Analysis of conversion rate (CR), laparoscopic success rate (LSR), mortality, and bile duct injury (BDI).
- Evaluation of factors including sex, age, ultrasound findings, cholecystitis severity, performance status, surgical timing, and percutaneous transhepatic gallbladder drainage (PTGBD).
Main Results:
- Increased cholecystitis severity correlated with higher mortality, CR, and lower LSR.
- Surgery within 72 hours demonstrated lower mortality, CR, and higher LSR compared to later surgery.
- Higher Charlson Comorbidity Index (CCI) was associated with increased mortality, CR, and decreased LSR.
Conclusions:
- Charlson Comorbidity Index (CCI) and cholecystitis severity are key predictors of CR and LSR.
- Early cholecystectomy (within 72 hours) is associated with improved surgical outcomes.
- Percutaneous transhepatic gallbladder drainage (PTGBD) offers a viable option for elderly, high-risk patients.
