alexa Should We must Push for Primary Surgery Attempt in Case
ISSN: 2165-7548

Emergency Medicine: Open Access
Open Access

OMICS International organises 3000+ Global Conferenceseries Events every year across USA, Europe & Asia with support from 1000 more scientific Societies and Publishes 700+ Open Access Journals which contains over 50000 eminent personalities, reputed scientists as editorial board members.

Open Access Journals gaining more Readers and Citations

700 Journals and 15,000,000 Readers Each Journal is getting 25,000+ Readers

This Readership is 10 times more when compared to other Subscription Journals (Source: Google Analytics)

Research Article

Should We must Push for Primary Surgery Attempt in Case of Acute Cholecystitis? A Retrospective Analysis and a Proposal of an Evidence based Clinical Pathway

Michele Pisano1, Marco Ceresoli1*, Luca Campanati1, Federico Coccolini1, Chiara Falcone2, Michela Giulii Capponi1, Fabrizio Palamara1, Dario Piazzalunga1,Elia Poiasina1, Alessandra Tebaldi3, Alberto Zucchi4 and Luca Ansaloni1

1General Surgery I Unit, Papa Giovanni XXIII Hospital, Bergamo, Italy

2Epidemiology, Papa Giovanni XXIII Hospital, Bergamo, Italy

3Infectious Disease Unit, Papa Giovanni XXIII Hospital, Bergamo, Italy

4Epidemiology, ASL Provincia di Bergamo, Italy

*Corresponding Author:
Marco Ceresoli
Chirurgia I, AO Papa Giovanni XXIII
Piazza OMS 1, 24127 Bergamo, Italy
Tel: 00390352673486
Fax: 00390352674963
Email: [email protected]

Received Date: May 16, 2014; Accepted Date: July 15, 2014; Published Date: July 25, 2014

Citation: Pisano M, Ceresoli M, Campanati L, Coccolini F, Falcone C, et al. (2014) Should We must Push for Primary Surgery Attempt in Case of Acute Cholecystitis? A Retrospective Analysis and a Proposal of an Evidence based Clinical Pathway . Emerg Med (Los Angel) 4:201. doi:10.4172/2165-7548.1000201

Copyright: © 2014 Pisano M, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

 

Abstract

The treatment and the correct management of acute calcolous cholecystitis (ACC), despite the presence of several studies, meta-analysis and guidelines are still debated and up to 80% of patients with ACC do not receive the definitive surgical treatment during the first hospital admission. A retrospective analysis of patients admitted with non-complicated acute cholecystitis in our hospital has been performed and on the basis of this analysis we proposed evidence based clinical pathway. 502 patients were selected, with a mean age of 62.09 years old, 56% of male sex and a mean Charlson comorbidity index of 2.96. 32.1% of the patients were not operated during all the observed period. Cholecystectomy during the first hospitalization was performed in 44.2% of the cases with a conversion rate of 15.34%, a cumulative hospital stay of 8.08 days and a mean cost of 3904 €. Delayed cholecystectomy after a mean of 119 days was chosen in 23.7% of the patients, 84.80% as elective procedure and 15.2% in urgency. Conversion rate was 13.7%. Cumulative hospital stay was 13.02 days and cumulative costs were 4660 €. Early cholecystectomy resulted better in term of cumulative hospital stay and costs (p<0.0001) without difference in term of conversion rate and complications, according to data in the literature. On the base of these considerations we propose an evidence based clinical pathway for the treatment of ACC.

Keywords

Share This Page

Additional Info

Loading
Loading Please wait..
 
Peer Reviewed Journals
 
Make the best use of Scientific Research and information from our 700 + peer reviewed, Open Access Journals
International Conferences 2017-18
 
Meet Inspiring Speakers and Experts at our 3000+ Global Annual Meetings

Contact Us

 
© 2008-2017 OMICS International - Open Access Publisher. Best viewed in Mozilla Firefox | Google Chrome | Above IE 7.0 version
adwords