Evidence map›Paper›PMID 33879993›Full record

ArticleJSLS : Journal of the Society of Laparoendoscopic Surgeons

Aggressive Laparoscopic Cholecystectomy in Accordance with the Tokyo Guideline 2018.

Naoto Takahashi, Akira Umemura, Takayuki Suto, Hisataka Fujiwara, Yu Ariyoshi, Hiroyuki Nitta, Takeshi Takahara, Yasushi Hasegawa, Akira Sasaki

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Article in JSLS : Journal of the Society of Laparoendoscopic Surgeons. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
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1 · What the graph read from it

What it found

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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

9 authors.

Naoto TakahashiDepartment of Surgery, Morioka Municipal Hospital, Morioka, Iwate, Japan.
Akira UmemuraDepartment of Surgery, Iwate Medical University, Iwate Prefecture, Japan.
Takayuki SutoDepartment of Surgery, Morioka Municipal Hospital, Morioka, Iwate, Japan.
Hisataka FujiwaraDepartment of Surgery, Morioka Municipal Hospital, Morioka, Iwate, Japan.
Yu AriyoshiDepartment of Surgery, Morioka Municipal Hospital, Morioka, Iwate, Japan.
Hiroyuki NittaDepartment of Surgery, Iwate Medical University, Iwate Prefecture, Japan.
Takeshi TakaharaDepartment of Surgery, Iwate Medical University, Iwate Prefecture, Japan.
Yasushi HasegawaDepartment of Surgery, Iwate Medical University, Iwate Prefecture, Japan.
Akira SasakiDepartment of Surgery, Iwate Medical University, Iwate Prefecture, Japan.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesThe Tokyo Guidelines 2018 have been widely adopted since their publication. However, the few reports on clinical outcomes following laparoscopic cholecystectomy have not taken into account the severity of the acute cholecystitis and the patient's general condition, as estimated by the Charlson comorbidity index. This study aimed to assess the relationships between severity, Charlson comorbidity index, and clinical outcomes subsequent to laparoscopic cholecystectomy.

methodsWe extracted the retrospective data for 370 Japanese patients who underwent emergency or scheduled early laparoscopic cholecystectomy within 72 hours from onset between February 2015 and August 2018. We compared postoperative factors in relationship to severity (grade I versus grade II/III). Then, we made a similar comparison between those with low (< 4) and high Charlson comorbidity index (≥ 4).

resultsAccording to the Tokyo guideline 2018 levels of severity, there were 282 (76.2%), 61 (16.5%), and 27 (7.3%) patients in grades I, II, and III, respectively. With regards to surgical outcomes, the mean operating time was 62.3 minutes and the mean blood loss was 24.4 mL. The mean hospital stay was 3.6 days, with no mortalities. Blood loss was the only factor affected by severity (20.9 mL versus 60.1 mL,

conclusionOur aggressive strategy is acceptable, and severity and Charlson comorbidity index are not critical factors suggesting the disqualification of early laparoscopic cholecystectomy in patients with any grade acute cholecystitis.

Indexed as

Cholecystectomy, LaparoscopicAdultAgedAged, 80 and overCholecystitis, AcuteFeasibility StudiesFemaleHumansJapanLength of StayMaleMiddle AgedOperative TimePatient SelectionPractice Guidelines as TopicRetrospective StudiesAcute CholecystitisCharlson Comorbidity IndexComprehensive Complication IndexLaparoscopic CholecystectomyTokyo Guideline 2018

Identifiers

PMID33879993
PMCPMC8035821

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.