Management Strategies for Acute Cholecystitis: Is the Timing of Surgery Important?

Ekinci, Özgür; GAPBAROV, Aman; EREN, Tunç; BEYAZADAM, Damla; ALİMOĞLU, Orhan; LEBLEBİCİ, Metin; BULUT, Nurgül

doi:10.4274/BMJ.galenos.2021.03411

Management Strategies for Acute Cholecystitis: Is the Timing of Surgery Important?

Özgür Ekinci, (İstanbul Medeniyet Üniversitesi Göztepe Şehir Hastanesi, Genel Cerrahi Anabilim Dalı, İstanbul, Türkiye)

Tunç Eren, (İstanbul Medeniyet Üniversitesi Göztepe Şehir Hastanesi, Genel Cerrahi Anabilim Dalı, İstanbul, Türkiye)

Aman Gapbarov, (İstanbul Medeniyet Üniversitesi Göztepe Şehir Hastanesi, Genel Cerrahi Anabilim Dalı, İstanbul, Türkiye)

Damla Beyazadam, (İstanbul Medeniyet Üniversitesi Göztepe Şehir Hastanesi, Genel Cerrahi Anabilim Dalı, İstanbul, Türkiye)

Nurgül Bulut, (İstanbul Medeniyet Üniversitesi, Biyoistatistik ve Tıp Bilişimi Anabilim Dalı, İstanbul, Türkiye)

Metin Leblebici, (İstanbul Medeniyet Üniversitesi Göztepe Şehir Hastanesi, Genel Cerrahi Anabilim Dalı, İstanbul, Türkiye)

Orhan Alimoğlu (İstanbul Medeniyet Üniversitesi Göztepe Şehir Hastanesi, Genel Cerrahi Anabilim Dalı, İstanbul, Türkiye)

Bakırköy Tıp Dergisi

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Yıl: 2021 Cilt: 17 Sayı: 4 Sayfa Aralığı: 312 - 319 Metin Dili: İngilizce DOI: 10.4274/BMJ.galenos.2021.03411 İndeks Tarihi: 20-05-2022

Management Strategies for Acute Cholecystitis: Is the Timing of Surgery Important?

Öz:

Objective: The timing of cholecystectomy is still controversial in acute cholecystitis (AC). This study aimed to evaluate the outcomes of early cholecystectomy (EC), delayed cholecystectomy (DC), and non-operative management (NOM) for AC. Methods: The patients with AC, who were treated in a one-year-period, were divided into EC, DC, and NOM subgroups. Parameters, including demographics, laboratory results, imaging findings, body mass index (BMI), American Society of Anesthesiologists (ASA) score, the timing of surgery, operative time, gallstone size, postoperative complications, and postoperative length of hospital stay were analyzed. Results: The study group of 125 patients comprised of 71 patients (56.8%) in the EC, 29 (23.2%) in the DC, and 25 patients (20%) in the NOM group. Patients in the NOM group were relatively older (p<0.05). BMI values and physical examination findings were similar among the subgroups (p>0.05). The incidence of ASA score of 3 and the mean levels of bilirubin, aspartate aminotransferase, and alanine aminotransferase was higher, whereas the mean hemoglobin value was lower in the NOM group (p<0.05). Gallstones smaller than 1 cm were more common in the DC group (p<0.05). The mean operative times, conversion rates, and postoperative complications were similar between the EC and DC groups (p>0.05). The length of hospital stay was shorter in the DC group (p<0.05). Conclusion: The surgical treatment of hospitalized patients with AC can be performed anytime within the first week of their admissions unless the clinical and laboratory findings render the patient unfit for surgery.

Anahtar Kelime:

Akut Kolesistit için Tedavi Stratejileri: Cerrahi Zamanlamasının Bir Önemi Var Mıdır?

Öz:

Amaç: Akut kolesistit (AK) olgularında kolesistektominin zamanlaması halen tartışmalıdır. Bu çalışmanın amacı, AK için erken kolesistektomi (EK), geç kolesistektomi (GK) ve non-operatif tedavi (NOT) sonuçlarının karşılaştırılmasıdır. Gereç ve Yöntem: Bir yıllık süreçte AK tanısıyla tedavi edilen hastalar EK, GK ve NOT alt gruplarına ayırıldı. Demografik veriler, laboratuvar sonuçları, görüntüleme bulguları, vücut kitle indeksi (VKİ), Amerikan Anestiyoloji Derneği (ASA) skoru, cerrahi zamanlaması, ameliyat süresi, safra taşı boyutu, postoperatif komplikasyonlar ve postoperatif hastanede yatış süresini içeren parametreler analiz edildi. Bulgular: Çalışmaya dahil olan 125 hastanın; 71’i (%56,8) EK grubunda, 29’u (%23,2) GK grubunda ve 25’i (%20) NOT grubundaydı. Hastalardan NOT grubunu oluşturanlar, göreceli olarak daha yaşlı idi (p<0,05). Çalışma alt grupları arasında VKİ değerleri ve fizik muayene bulguları benzerdi (p>0,05). Alt gruplardan NOT grubunda; ASA 3 skoru sıklığı, ortalama bilirubin değerleri ile aspartat aminotransferaz ve alanin aminotransferaz değerleri daha yüksek iken ortalama hemoglobin değeri daha düşüktü (p<0,05). Boyutları 1 cm’den küçük safra taşları GK grubunda daha sık olarak gözlendi (p<0,05). Ortalama ameliyat süresi, açık ameliyata geçiş oranları ve postoperatif komplikasyon oranları EK ve GK grupları arasında benzer saptandı (p>0,05). Hastanede yatış süresinin GK grubunda daha kısa olduğu gözlendi (p<0,05).Sonuç: Klinik ve laboratuvar bulguları hastanın ameliyat için uygun olmadığını göstermediği sürece, akut kolesistit olgularının cerrahi tedavisi, hastaneye yatışın ilk haftası içerisinde herhangi bir zamanda gerçekleştirilebilir.

Anahtar Kelime:

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık

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APA	Ekinci Ö, EREN T, GAPBAROV A, BEYAZADAM D, BULUT N, LEBLEBİCİ M, ALİMOĞLU O (2021). Management Strategies for Acute Cholecystitis: Is the Timing of Surgery Important?. , 312 - 319. 10.4274/BMJ.galenos.2021.03411
Chicago	Ekinci Özgür,EREN Tunç,GAPBAROV Aman,BEYAZADAM Damla,BULUT Nurgül,LEBLEBİCİ Metin,ALİMOĞLU Orhan Management Strategies for Acute Cholecystitis: Is the Timing of Surgery Important?. (2021): 312 - 319. 10.4274/BMJ.galenos.2021.03411
MLA	Ekinci Özgür,EREN Tunç,GAPBAROV Aman,BEYAZADAM Damla,BULUT Nurgül,LEBLEBİCİ Metin,ALİMOĞLU Orhan Management Strategies for Acute Cholecystitis: Is the Timing of Surgery Important?. , 2021, ss.312 - 319. 10.4274/BMJ.galenos.2021.03411
AMA	Ekinci Ö,EREN T,GAPBAROV A,BEYAZADAM D,BULUT N,LEBLEBİCİ M,ALİMOĞLU O Management Strategies for Acute Cholecystitis: Is the Timing of Surgery Important?. . 2021; 312 - 319. 10.4274/BMJ.galenos.2021.03411
Vancouver	Ekinci Ö,EREN T,GAPBAROV A,BEYAZADAM D,BULUT N,LEBLEBİCİ M,ALİMOĞLU O Management Strategies for Acute Cholecystitis: Is the Timing of Surgery Important?. . 2021; 312 - 319. 10.4274/BMJ.galenos.2021.03411
IEEE	Ekinci Ö,EREN T,GAPBAROV A,BEYAZADAM D,BULUT N,LEBLEBİCİ M,ALİMOĞLU O "Management Strategies for Acute Cholecystitis: Is the Timing of Surgery Important?." , ss.312 - 319, 2021. 10.4274/BMJ.galenos.2021.03411
ISNAD	Ekinci, Özgür vd. "Management Strategies for Acute Cholecystitis: Is the Timing of Surgery Important?". (2021), 312-319. https://doi.org/10.4274/BMJ.galenos.2021.03411

APA	Ekinci Ö, EREN T, GAPBAROV A, BEYAZADAM D, BULUT N, LEBLEBİCİ M, ALİMOĞLU O (2021). Management Strategies for Acute Cholecystitis: Is the Timing of Surgery Important?. Bakırköy Tıp Dergisi, 17(4), 312 - 319. 10.4274/BMJ.galenos.2021.03411
Chicago	Ekinci Özgür,EREN Tunç,GAPBAROV Aman,BEYAZADAM Damla,BULUT Nurgül,LEBLEBİCİ Metin,ALİMOĞLU Orhan Management Strategies for Acute Cholecystitis: Is the Timing of Surgery Important?. Bakırköy Tıp Dergisi 17, no.4 (2021): 312 - 319. 10.4274/BMJ.galenos.2021.03411
MLA	Ekinci Özgür,EREN Tunç,GAPBAROV Aman,BEYAZADAM Damla,BULUT Nurgül,LEBLEBİCİ Metin,ALİMOĞLU Orhan Management Strategies for Acute Cholecystitis: Is the Timing of Surgery Important?. Bakırköy Tıp Dergisi, vol.17, no.4, 2021, ss.312 - 319. 10.4274/BMJ.galenos.2021.03411
AMA	Ekinci Ö,EREN T,GAPBAROV A,BEYAZADAM D,BULUT N,LEBLEBİCİ M,ALİMOĞLU O Management Strategies for Acute Cholecystitis: Is the Timing of Surgery Important?. Bakırköy Tıp Dergisi. 2021; 17(4): 312 - 319. 10.4274/BMJ.galenos.2021.03411
Vancouver	Ekinci Ö,EREN T,GAPBAROV A,BEYAZADAM D,BULUT N,LEBLEBİCİ M,ALİMOĞLU O Management Strategies for Acute Cholecystitis: Is the Timing of Surgery Important?. Bakırköy Tıp Dergisi. 2021; 17(4): 312 - 319. 10.4274/BMJ.galenos.2021.03411
IEEE	Ekinci Ö,EREN T,GAPBAROV A,BEYAZADAM D,BULUT N,LEBLEBİCİ M,ALİMOĞLU O "Management Strategies for Acute Cholecystitis: Is the Timing of Surgery Important?." Bakırköy Tıp Dergisi, 17, ss.312 - 319, 2021. 10.4274/BMJ.galenos.2021.03411
ISNAD	Ekinci, Özgür vd. "Management Strategies for Acute Cholecystitis: Is the Timing of Surgery Important?". Bakırköy Tıp Dergisi 17/4 (2021), 312-319. https://doi.org/10.4274/BMJ.galenos.2021.03411