ArticleBMC surgery2017
Risk factors for difficulty of laparoscopic cholecystectomy in grade II acute cholecystitis according to the Tokyo guidelines 2013.
Article in BMC surgery, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers.
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24 citing papers in PubMed, 51 citations in OpenAlex.
- Validation of a nomogram with inflammation-based markers developed to predict difficult laparoscopic cholecystectomy in patients with acute cholecystitis.Surgery today · 2026Article
- Preoperative difficulty assessment of laparoscopic cholecystectomy after treatment for choledocholithiasis.Surgical endoscopy · 2026Article
- Cystic duct management in subtotal cholecystectomy: is closure necessary?Surgery today · 2026Article
- Article
- Predicting the surgical difficulty of laparoscopic cholecystectomy after percutaneous transhepatic gallbladder drainage in patients with acute cholecystitis: a multi-center study.Updates in surgery · 2026Article
- Predicting the timing of LC after PTGBD in elderly patients with acute cholecystitis: a machine learning approach with a web-based calculator.Langenbeck's archives of surgery · 2025Article
- Establishment and Application of a Grading Management Model for Laparoscopic Cholecystectomy.Medical science monitor : international medical journal of experimental and clinical research · 2025Article
- A Comparative Study of Laparoscopic Versus Robotic Cholecystectomies Based on the Parkland Grading Scale.Cureus · 2024Article
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- Prognostic factors and predictive models in hot gallbladder surgery: A prospective observational study in a high-volume center.Annals of hepato-biliary-pancreatic surgery · 2024Article
- Pre-Operative Group and Save in Elective and Emergency Laparoscopic Cholecystectomy: Necessity, Cost-Effectiveness, and Own Experience.Journal of clinical medicine · 2024Article
- Learning curve of laparoscopic cholecystectomy: a risk-adjusted cumulative summation (RA-CUSUM) analysis of six general surgery residents.Surgical endoscopy · 2023Article
- The Association of Polish Surgeons (APS) clinical guidelines for the use of laparoscopy in the management of abdominal emergencies. Part I.Wideochirurgia i inne techniki maloinwazyjne = Videosurgery and other miniinvasive techniques · 2023Article
- Utility of the Parkland Grading Scale to determine intraoperative challenges during laparoscopic cholecystectomy: a validation study on 206 patients at an academic medical center in Nepal.Patient safety in surgery · 2023Article
- Correlation of Inpatients Suffering from Acute Acalculous Cholecystitis during ICU Treatment with Acute Physiology and Chronic Health Evaluation II Score, Duration of Ventilator Use, and Time on Total Parenteral Nutrition.Computational and mathematical methods in medicine · 2022Article
- Gallbladder adhesion degree as predictor of conversion surgery, common bile duct injury and resurgery in laparoscopic cholecystectomy: A cross-sectional study.Annals of medicine and surgery (2012) · 2021Article
- Less is more in the difficult gallbladder: recent evolution of subtotal cholecystectomy in a single HPB unit.Surgical endoscopy · 2021Article
- Treatment of acute suppurative cholecystitis with coagulopathy by percutaneous transhepatic gallbladder drainage after hepatic needle-track ablation: report of a new technique.Quantitative imaging in medicine and surgery · 2021Article
- Impacts on outcomes and management of preoperative magnetic resonance cholangiopancreatography in patients scheduled for laparoscopic cholecystectomy: for whom it should be considered?Annals of surgical treatment and research · 2020Article
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10 authors at 3 institutions in 1 country.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundThe Tokyo Guidelines 2013 classifies acute cholecystitis (AC) into three grades and recommends appropriate therapy for each grade. For grade II AC, either early laparoscopic cholecystectomy (LC) or percutaneous transhepatic gallbladder drainage (PTGBD) should be performed. This study aimed to identify the risk factors for difficulty of LC for treating grade II AC.
methodsTotally, 122 patients who underwent LC for grade II AC were enrolled and divided into difficult LC (DLC) and nondifficult LC (NDLC) groups. The DLC group included patients who experienced one of the following conditions: conversion from LC to open cholecystectomy, operating time ≥ 180 min, or blood loss ≥300 ml. Preoperative characteristics and postoperative outcomes were analyzed.
resultsIn univariate analysis, risk factors included male sex, interval between symptom onset and admission, interval between symptom onset and LC, and anticoagulant therapy. The incidence of postoperative complications was higher in the DLC group than in the NDLC group (23.5% vs. 4.6%, p = 0.0016). According to receiver operating characteristic curves, the optimal cutoff value was calculated, and multivariate analysis showed that male sex [odds ratio (OR), 5.76; 95% confidence interval (CI), 1.979-19.51; p = 0.0009) and interval between symptom onset and LC of over 96 h (OR, 6.32; 95% CI, 2.126-20.15; p = 0.0009) were independent risk factors for difficulty of LC.
conclusionsIn patients with grade II AC, LC was technically difficult when performed over 96 h after symptom onset. Moreover, male sex was a risk factor. Therefore, PTGBD should be considered in these patients.
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