ArticleWorld journal of emergency surgery : WJES2015
Critically ill patients with acute cholecystitis are at increased risk for extensive gallbladder inflammation.
Article in World journal of emergency surgery : WJES, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 1 of them a synthesis that pooled it.
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Who cites it
11 citing papers in PubMed, 1 synthesis or guideline pooled it, 22 citations in OpenAlex.
- The Treatment of Critically Ill Patients With Acute Cholecystitis.Deutsches Arzteblatt international · 2016Pooled it
- Preoperative prediction model for critical view of safety achievement in laparoscopic cholecystectomy: a retrospective cohort study.Surgical endoscopy · 2026Article
- Safety and Feasibility of Early Laparoscopic Cholecystectomy in High-Risk Acute Cholecystitis: A Critical Evaluation of Tokyo Guidelines 2018 Risk Stratification.World journal of surgery · 2026Article
- Might simple peripheral blood parameters be an early indicator in the prediction of severity and morbidity of cholecystitis?Annals of surgical treatment and research · 2023Article
- Patient and surgeon factors contributing to bailout cholecystectomies: a single-institutional retrospective analysis.Surgical endoscopy · 2022Article
- Retrospective Analysis of Outcomes Following Percutaneous Cholecystostomy for Acute Cholecystitis.World journal of surgery · 2020Article
- Advanced gallbladder inflammation is a risk factor for gallbladder perforation in patients with acute cholecystitis.World journal of emergency surgery : WJES · 2018Article
- Outcome of acute perforated cholecystitis: a register study of over 5000 cases from a quality control database in Germany.Surgical endoscopy · 2017Article
- Effectiveness of Guideline-Recommended Cholecystectomy to Prevent Recurrent Pancreatitis.The American journal of gastroenterology · 2017Article
- Hybrid Percutaneous-Endoscopic Treatment for Acute Calculous Cholecystitis in a High-Risk Surgical Patient.ACG case reports journal · 2017Article
- Surgical management of empyematous cholecystitis: a register study of over 12,000 cases from a regional quality control database in Germany.Surgical endoscopy · 2016Article
Corrections and comments
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Authors and funding
3 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAcute cholecystitis is a common diagnosis and surgery is the standard of care for young and fit patients. However, due to high risk of postoperative morbidity and mortality, surgical management of critically ill patients remains a controversy. It is not clear, whether the increased risk of perioperative complications associated with the management of critically ill patients with acute cholecystitis is secondary to reduced physiologic reserve per se or to the severity of gallbladder inflammation.
methodsA retrospective analysis of prospectively collected data of patients undergoing laparoscopic cholecystectomy for acute cholecystitis in a university hospital over a three-year-period was performed. The ASA scores at the time of presentation were used to categorize patients into two groups. The study group consisted of critically ill patients with ASA 3 and 4, while the control group was made up of fit patients with ASA 1 and 2. Both groups were compared with regard to perioperative data, postoperative outcome and extent of gallbladder inflammation on histopathology.
resultsTwo hundred and seventeen cases of acute cholecystitis with complete charts were available for analysis. The study group included 67 critically ill patients with ASA 3 and 4, while the control group included 150 fit patients with ASA 1 and 2. Both groups were comparable with regard to perioperative data. Histopathology confirmed severe cholecystitis in a significant number of cases in the study group compared to the control group (37 % vs. 18 %, p = 0.03). Significantly higher rates of morbidity and mortality were recorded in the study group (p < 0.05). Equally, significantly more patients from the study group were managed in the ICU (40 % vs. 8 %, p = 0.001).
conclusionCritically ill patients presenting with acute cholecystitis are at increased risk for extensive gallbladder inflammation. The increased risk of morbidity and mortality seen in such patients might partly be secondary to severe acute cholecystitis.
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