ArticleCanadian journal of surgery. Journal canadien de chirurgie2020
Diagnosis and management of acute cholecystitis: a single-centre audit of guideline adherence and patient outcomes.
Article in Canadian journal of surgery. Journal canadien de chirurgie, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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Who cites it
6 citing papers in PubMed, 9 citations in OpenAlex.
- An artificial intelligence-based navigation system for enhancing anatomical recognition and safety during laparoscopic cholecystectomy: a pilot study.International journal of surgery (London, England) · 2026Article
- Prognostic role of systemic inflammatory indices in predicting the severity of acute calculous cholecystitis.Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES · 2026Article
- Evaluation of microbiological cultures in patients with acute cholecystitis.Frontiers in surgery · 2026Article
- Acute cholecystitis management at a tertiary care center: are we following current guidelines?Langenbeck's archives of surgery · 2024Article
- The snapshot audit methodology: design, implementation and analysis of prospective observational cohort studies in surgery.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2023Review
- Letter to Editor: Incidence and risk factors of acute cholecystitis after cardiovascular surgery.General thoracic and cardiovascular surgery · 2022Article
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Authors and funding
7 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: The Tokyo Guidelines were published in 2007 and updated in 2013 and 2018, with recommendations for the diagnosis and management of acute cholecystitis. We assessed guideline adherence at our academic centre and its impact on patient outcomes. Methods: This is a retrospective chart review of patients with acute calculous cholecystitis who underwent cholecystectomy at our institution between November 2013 and March 2015. Severity of cholecystitis was graded retrospectively if it had not been documented preoperatively. Compliance with the Tokyo Guidelines' recommendations on antibiotic use and time to operation was recorded. Cholecystitis severity groups were compared statistically, and logistic regression was used to determine predictors of complications. Results: One hundred and fifty patients were included in the study. Of these, 104 patients were graded as having mild cholecystitis, 45 as having moderate cholecystitis, and 1 as having severe cholecystitis. Severity was not documented preoperatively for any patient. Compliance with antibiotic recommendations was poor (18.0%) and did not differ by cholecystitis severity (p = 0.90). Compliance with the recommendation on time to operation was 86.0%, with no between-group differences (p = 0.63); it improved when an acute care surgery team was involved (91.0% v. 76.0%, p = 0.025). On multivariable analysis, comorbidities (odds ratio [OR] 1.47, 95% confidence interval [CI] 1.19-1.85, p < 0.001) and conversion to laparotomy (OR 13.45, 95% CI 2.16-125.49, p = 0.01) predicted postoperative complications, while severity of cholecystitis, antibiotic compliance and time to operation had no effect. Conclusion: In this study, compliance with the Tokyo Guidelines was acceptable only for time to operation. Although the poor compliance with recommendations relating to documentation of severity grading and antibiotic use did not have a negative affect on patient outcomes, these recommendations are important because they facilitate appropriate antibiotic use and patient risk stratification.
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