A retrospective analysis of the treatment results of 1557 patients with acute cholecystitis.
OBJECTIVE
To analyse outcomes of variable management strategies for the treatment of Acute Cholecystitis in relation to morbidity, mortality and conversion to open surgery.


METHODS
The retrospective study was conducted at Firat University Hospital, Turkey and comprised records of Acute Cholecystitis patients admitted between 2005 and 2011. Patients were divided into subgroups according to admission time as well as American Society of Anaesthesiologists score. The outcomes of early cholecystectomy, interval cholecystectomy, delayed cholecystectomy, 'cooling-off' therapy and percutaneous cholecystostomy were evaluated. Mortality, morbidity, and conversion to open surgery were calculated as measures of success. Data was analysed using SPSS.


RESULTS
Of the 1557 patients, 1052(67.6%) were female. The overall mean age was 42.4±14.7 years. Success rates of 'cooling-off' therapy and percutaneous cholecystostomy were 89.3% and 96.3%, respectively. The conversion rate following delayed cholecystectomy was 30%, which was higher than that of both early and interval cholecystectomy (0.2% and 0%, respectively; p<0.001 each). Mortality and morbidity rates of delayed cholecystectomy (57.1% and 7.1%, respectively) were also significantly higher than early and interval cholecystectomy (5% and 0.1%; 5.6 and 0%, respectively).


CONCLUSIONS
Early laparoscopic cholecystectomy and interval cholecystectomy shared similar outcomes and rates of efficacy. Percutaneous cholecystostomy was a successful treatment option for high-risk patients, while delayed cholecystostomy correlated to the highest rates of conversion to open surgery, mortality and morbidity.
Firat University, Medical Faculty, Department of General Surgery, Elazig, Turkey.
Cuneyt
C
Kirkil
Firat University, Medical Faculty, Department of General Surgery, Elazig, Turkey.
Yavuz Selim
YS
Ilhan
Firat University, Medical Faculty, Department of General Surgery, Elazig, Turkey.
Erhan
E
Aygen
Ataturk Teaching and Education Hospital, Department of General Surgery, Antalya,Turkey.
Nurullah
N
Bulbuller
Harput State Hospital, Department of General Surgery, Elazig, Turkey.
Baris
B
Gulturk
Gazi State Hospital, Department of General Surgery, Samsun, Turkey.
Serdar
S
Coskun
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D002763:Cholecystectomy; D017081:Cholecystectomy, Laparoscopic / Q000379:methods*; D041881:Cholecystitis, Acute / Q000628:therapy*; D002767:Cholecystostomy / Q000379:methods*; D015331:Cohort Studies; D061887:Conversion to Open Surgery / Q000706:statistics & numerical data*; D005260:Female; D005440:Fluid Therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D012189:Retrospective Studies; D018570:Risk Assessment; D013997:Time Factors; D014421:Turkey; D055815:Young Adult
D000900:Anti-Bacterial Agents
Cholecystitis, Laparoscopic, Cholecystostomy.