title: Impact of comorbidities on the postoperative outcomes of acute cholecystitis following early cholecystectomy.
abstract: OBJECTIVE
  The purpose of this study was to evaluate the influence of comorbidities on the surgical outcomes of early cholecystectomy for acute cholecystitis.
  
  
  METHODS
  Data were retrospectively collected for patients with acute cholecystitis who underwent early cholecystectomy. Patients were separated into three groups based on the cholecystitis severity grade, and the surgical outcomes of early cholecystectomy were analyzed. Patients with mild and moderate cholecystitis were subdivided into a comorbidity group (n = 10) and a non-comorbidity group (n = 83).
  
  
  RESULTS
  There were 57 (55.3%) patients with mild cholecystitis, 36 (35.0%) with moderate cholecystitis, and 10 (9.7%) with severe cholecystitis. The surgical outcomes were significantly worse for patients with severe cholecystitis than for patients with mild or moderate cholecystitis. There were no postoperative deaths after cholecystectomy. There were no significant differences in the complication rate (P = 0.629), conversion rate (P = 0.114), or intraoperative blood loss (P = 0.147) between the comorbidity and non-comorbidity groups.
  
  
  CONCLUSIONS
  Our findings suggest that early cholecystectomy can be performed safely for patients with mild and moderate cholecystitis even if comorbidities are present. Early cholecystectomy may be an alternative treatment strategy for patients with severe cholecystitis who are candidates for anesthesia and surgery.
authors.affiliation: Department of Surgery, Onomichi General Hospital, 1-10-23, Onomichi, Hiroshima, Japan.|Department of Gastroenterological and Transplant Surgery, Applied Life Sciences, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan.
authors.forename: Ryusuke
authors.initials: R
authors.lastname: Saito
authors.affiliation: Department of Surgery, Onomichi General Hospital, 1-10-23, Onomichi, Hiroshima, Japan. t.abe.hiroshima@gmail.com.|Department of Gastroenterological and Transplant Surgery, Applied Life Sciences, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan. t.abe.hiroshima@gmail.com.
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Abe
authors.affiliation: Department of Gastroenterology, Onomichi General Hospital, Onomichi, Hiroshima, Japan.
authors.forename: Keiji
authors.initials: K
authors.lastname: Hanada
authors.affiliation: Department of Gastroenterology, Onomichi General Hospital, Onomichi, Hiroshima, Japan.
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Minami
authors.affiliation: Department of Surgery, Onomichi General Hospital, 1-10-23, Onomichi, Hiroshima, Japan.
authors.forename: Nobuaki
authors.initials: N
authors.lastname: Fujikuni
authors.affiliation: Department of Gastroenterological and Transplant Surgery, Applied Life Sciences, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan.
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Kobayashi
authors.affiliation: Department of Surgery, Onomichi General Hospital, 1-10-23, Onomichi, Hiroshima, Japan.
authors.forename: Hironobu
authors.initials: H
authors.lastname: Amano
authors.affiliation: Department of Gastroenterological and Transplant Surgery, Applied Life Sciences, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan.
authors.forename: Hideki
authors.initials: H
authors.lastname: Ohdan
authors.affiliation: Department of Surgery, Onomichi General Hospital, 1-10-23, Onomichi, Hiroshima, Japan.
authors.forename: Toshio
authors.initials: T
authors.lastname: Noriyuki
authors.affiliation: Department of Surgery, Onomichi General Hospital, 1-10-23, Onomichi, Hiroshima, Japan.
authors.forename: Masahiro
authors.initials: M
authors.lastname: Nakahara
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002763:Cholecystectomy; D041881:Cholecystitis, Acute / Q000453:epidemiology* / Q000601:surgery*; D015897:Comorbidity; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017410:Practice Guidelines as Topic; D012189:Retrospective Studies; D012720:Severity of Illness Index; D016896:Treatment Outcome; D055815:Young Adult
keywords: 2013 Tokyo guideline; Acute cholecystitis; Comorbidity; Early cholecystectomy; Severe cholecystitis