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[Acute cholecystitis: timing of surgery]

R D'Ambrosio1, L Leone, C Peppas

  • 1Dipartimento di Emergenze, Ospedale A Cardarelli, Regione Campania, USL n. 40, Napoli.

Minerva Chirurgica
|January 1, 1995
PubMed
Summary

This study on acute cholecystitis found that early surgery, guided by emergency echography, yielded satisfactory results with low mortality and complications. Treatment timing significantly impacts outcomes for this gallbladder inflammation.

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Area of Science:

  • Gastroenterology and Hepatology
  • Surgical Gastroenterology
  • Diagnostic Imaging

Background:

  • Acute cholecystitis is a common surgical emergency.
  • Management strategies, including timing of intervention, are debated.
  • Diagnostic advancements like emergency echography have evolved patient assessment.

Purpose of the Study:

  • To analyze the experience of 156 acute cholecystitis cases.
  • To evaluate the impact of surgical timing on treatment outcomes.
  • To contribute to the codification of acute cholecystitis management.

Main Methods:

  • Retrospective analysis of 156 patients with acute cholecystitis (Jan 1991-Oct 1992).
  • Review of treatment approaches: non-operative (27 cases) and surgical (129 cases).

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  • Emphasis on diagnostic role of emergency echography and analysis of surgical timing (early vs. delayed).

    • Main Results:

    • Echography is considered indispensable for emergency diagnosis.
    • 110 surgeries were performed within 12 hours, 19 between 12-72 hours.
    • Low mortality (0.78%) and acceptable complication rates (7.75% immediate, 1.55% late) were observed with surgical management.

    Conclusions:

    • Early surgical intervention in acute cholecystitis is associated with satisfactory outcomes.
    • Emergency echography is crucial for prompt diagnosis and management planning.
    • The timing of surgery is a critical factor influencing therapeutic results.