ArticleUlusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES2022
Should the severity of acute cholecystitis (Tokyo 2018 guideline) affect the decision of early or delayed cholecystectomy?
Article in Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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3 citing papers in PubMed, 1 citations in OpenAlex.
- Outcomes of acute moderate cholecystitis management techniques: percutaneous transhepatic gallbladder drainage and early laparoscopic cholecystectomy.Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES · 2026Article
- 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
- Development and external validation of a machine learning model for predicting gangrenous cholecystitis.Frontiers in medicine · 2026Article
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2 authors at 1 institution in 1 country.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundIn our study, we aimed to compare the complication rates of patients presenting with acute cholecystitis and undergoing surgery at the time of hospitalization (early cholecystectomy) and delayed cholecystectomy and also to examine whether the severity of cholecystitis has an effect on the timing of cholecystectomy.
methodsThe study was planned retrospectively and the approval of the ethics committee of our hospital was obtained. The patient files of the patients who were admitted to our tertiary hospital with acute cholecystitis were accessed through the hospital archive system. The patients were divided into two groups, those who were admitted to the emergency department for acute chole-cystitis and who underwent early cholecystectomy and delayed cholecystectomy. The Tokyo 2018 acute cholecystitis guideline was used to determine the severity of acute cholecystitis. Pre-operative and post-operative data of the patients were examined and their complications were evaluated.
resultsThe data of 158 patients who met the inclusion criteria were retrospectively analyzed. Compared with delayed chole-cystectomy, complication rates increased in patients who underwent early cholecystectomy (8.1% and 32.2%, respectively, p<0.001). According to the Tokyo 2018 guideline, patients with acute cholecystitis were grouped as Tokyo 1, 2, and 3; and of Tokyo 1 patients, more complications were observed in those who underwent early cholecystectomy (22.6% and 4.2%, respectively, p=0.004). When the complications were examined, it was observed that pulmonary embolism, pneumonia, intra-abdominal abscess development, sepsis, and wound infection were significantly higher in those who were operated early. When the factors affecting complications are examined, having a Tokyo score of 2 and above (OR: 4.161), high creatinine levels (OR: 5.496), and presence of additional disease (OR: 4.238) increase the risk of developing complications.
conclusionMore complications occur after cholecystectomy in patients with Tokyo 2 and above, when compared with patients with Tokyo 1. It was observed that more complications developed in patients with Tokyo 1 cholecystitis who were operated in the early period. Further studies are needed to determine the effect of acute cholecystitis severity in determining the timing of cholecystectomy.
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