Evidence map›Paper›PMID 39354370›Full record

ArticleBMC gastroenterology2024

Multicenter analysis of the efficacy of early cholecystectomy and preoperative cholecystostomy for severe acute cholecystitis: a retrospective study of data from the multi-institutional database of the Hiroshima Surgical Study Group of Clinical Oncology.

Tomoyuki Abe, Tsuyoshi Kobayashi, Shintaro Kuroda, Michinori Hamaoka, Hiroaki Mashima, Takashi Onoe, Naruhiko Honmyo, Koichi Oishi, Hideki Ohdan

Abstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in BMC gastroenterology, 2024. 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
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

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.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Tomoyuki AbeDepartment of Gastroenterological Surgery, National Hospital Organization Higashihiroshima Medical Center, 513, Jike, Saijo-cho, Higashihiroshima, 739-0041, Hiroshima, Japan. t.abe.hiroshima@gmail.com.
Tsuyoshi KobayashiDepartment of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Science, Hiroshima University, Hiroshima, Japan.
Shintaro KurodaDepartment of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Science, Hiroshima University, Hiroshima, Japan.
Michinori HamaokaDepartment of Surgery, Hiroshima Prefectural Hospital, Hiroshima, Japan.
Hiroaki MashimaDepartment of Surgery, Onomichi General Hospital, Onomichi, Japan.
Takashi OnoeDepartment of Surgery, Kure Medical Center and Chugoku Cancer Center, Kure, Japan.
Naruhiko HonmyoDepartment of Surgery, Hiroshima City Asa Citizens Hospital, Hiroshima, Japan.
Koichi OishiDepartment of Surgery, Chugoku Rosai Hospital, Kure, Japan.
Hideki OhdanDepartment of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Science, Hiroshima University, Hiroshima, Japan.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundSevere acute cholecystitis (AC) is a challenging disease because it comprises coexisting systemic infections that lead to vital organ dysfunction. This study evaluated the optimal surgical timing and efficacy of preoperative percutaneous cholecystostomy (PC) for patients with severe AC.

methodsData of 142 patients who underwent cholecystectomy for severe AC between 2011 and 2021 were retrospectively collected from the multi-institutional database of the Hiroshima Surgical Study Group of Clinical Oncology. Patients were divided into the early cholecystectomy (EC) group (within 72 h of symptom onset) and delayed cholecystectomy (DC) group. They were also subdivided into the upfront cholecystectomy group and preoperative PC before cholecystectomy group. The diagnosis and severity of AC were graded according to the Tokyo Guidelines 2018. Clinicopathological variables and outcomes were compared.

resultsNo significant differences in age, body mass index, American Society of Anesthesiologists (ASA) classification, and Charlson comorbidity index between the EC and DC groups were observed. Preoperative drainage was more commonly performed for the DC group than for the EC group. Local severe AC features were more commonly detected in the DC group than in the EC group. The postoperative outcomes of the EC and DC groups were comparable. Compared to the PC before cholecystectomy group, the upfront cholecystectomy group included more patients with ASA physical status ≥ 3 and more patients who used oral warfarin. Warfarin usage and cardiovascular dysfunction rates of the PC after cholecystectomy group were higher than those of the upfront cholecystectomy group. PC was associated with significantly less intraoperative bleeding and shorter hospital stays.

conclusionsPatients who can tolerate general anesthesia are good candidates for EC. Patients who use warfarin and those with cardiovascular dysfunction are considered to be at high risk for postoperative complications; therefore, to prevent AC recurrence during the waiting period, PC before cholecystectomy during the same admission is more appropriate than upfront cholecystectomy for these patients.

Indexed as

CholecystectomyCholecystitis, AcuteCholecystostomyPreoperative CareAgedAged, 80 and overDatabases, FactualFemaleHumansJapanLength of StayMaleMiddle AgedPostoperative ComplicationsRetrospective StudiesSeverity of Illness IndexEarly cholecystectomySevere acute cholecystitisTokyo guidelines 2018

Identifiers

PMID39354370
PMCPMC11443758

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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.