alexa Early versus delayed surgery for acute cholecystitis as an applied treatment strategy when assessed in a population-based cohort.


Journal of Gastrointestinal & Digestive System

Author(s): Pieniowski E, Popowicz A, Lundell L, Gerber P, Gustafsson U,

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Abstract BACKGROUND: The aims of this study were to describe the surgical management of acute cholecystitis (AC) in a well-defined population-based patient cohort, in particular adherence to and outcome of the early open/laparoscopic cholecystectomy (EC/ELC) strategy. METHODS: The medical records of all patients residing in Stockholm County who were treated for AC during 2003 and 2008 were reviewed according to a standardized protocol. RESULTS: In 2003, 799 patients were admitted 850 times for AC, and the respective figures for 2008 were 833 and 919. The number of patients who underwent EC/ELC increased from 42.9\% in 2003 to 47.4\% in 2008. In multivariate regression analysis adjusting for age, gender, severity of cholecystitis, maximal CRP and maximal WBC, EC/ELC was associated with shorter operation time but higher perioperative blood loss when compared to delayed open/laparoscopic cholecystectomy (DC/DLC). The odds ratio for completing the procedure laparoscopically was significantly higher in DC/DLC when adjusting for the same covariates. There were no significant differences in peri- or postoperative complications between the groups. CONCLUSION: Strategies should be implemented in order to secure a more evidence-based approach to the surgical treatment of AC. © 2014 S. Karger AG, Basel. This article was published in Dig Surg and referenced in Journal of Gastrointestinal & Digestive System

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