Acute cholecystitis: WSES position statement

Fabio Cesare Campanile, Michele Pisano, Federico Coccolini, Fausto Catena, Ferdinando Agresta, Luca Ansaloni, Fabio Cesare Campanile, Michele Pisano, Federico Coccolini, Fausto Catena, Ferdinando Agresta, Luca Ansaloni

Abstract

Background: The management of acute calculous cholecystitis still offers room for debate in terms of diagnosis, severity scores, treatment options and timing for surgery.

Material and methods: A systematic review about the treatment of acute cholecystitis has been completed. The recommendations of recent guidelines have also been examined taking into account the results of the review.

Results: The evidence available in the literature supports the recommendation about laparoscopic cholecystectomy as treatment of choice for acute cholecystitis. Surgery should be performed as soon as possible after the diagnosis because early treatment reduces total hospital stay and does not increase complication or conversion rates. The antibiotics can play different roles and attention should be posed to the risk of emerging resistance. A surgical or percutaneous drainage of the gallbladder is advocated by some authors in the advanced forms of inflammation or patients with severe co-morbidities; however, the available evidence does not support it, and further studies are necessary to clarify its role.

References

    1. Agresta F, Ansaloni L, Baiocchi GL, Bergamini C, Campanile FC, Carlucci M, Cocorullo G, Corradi A, Franzato B, Lupo M, Mandalà V, Mirabella A, Pernazza G, Piccoli M, Staudacher C, Vettoretto N, Zago M, Lettieri E, Levati A, Pietrini D, Scaglione M, De Masi S, De Placido G, Francucci M, Rasi M, Fingerhut A, Uranüs S, Garattini S. Laparoscopic approach to acute abdomen from the Consensus Development Conference of the Società Italiana di Chirurgia Endoscopica e nuove tecnologie (SICE), Associazione Chirurghi Ospedalieri Italiani (ACOI), Società Italiana di Chirurgia (SIC), Società Italiana di Chirurgia d’Urgenza e del Trauma (SICUT), Società Italiana di Chirurgia nell’Ospedalità Privata (SICOP), and the European Association for Endoscopic Surgery (EAES) Surg Endosc. 2012;26:2134–2164. doi: 10.1007/s00464-012-2331-3.
    1. Yamashita Y, Takada T, Kawarada Y, Nimura Y, Hirota M, Miura F, Mayumi T, Yoshida M, Strasberg S, Pitt HA, de Santibanes E, Belghiti J, Büchler MW, Gouma DJ, Fan ST, Hilvano SC, Lau JW, Kim SW, Belli G, Windsor JA, Liau KH, Sachakul V. Surgical treatment of patients with acute cholecystitis: Tokyo guidelines. J Hepatobiliary Pancreat Surg. 2007;14:91–97. doi: 10.1007/s00534-006-1161-x.
    1. Yamashita Y, Takada T, Strasberg SM, Pitt HA, Gouma DJ, Garden OJ, Büchler MW, Gomi H, Dervenis C, Windsor JA, Kim S-W, de Santibanes E, Padbury R, Chen X-P, Chan ACW, Fan S-T, Jagannath P, Mayumi T, Yoshida M, Miura F, Tsuyuguchi T, Itoi T, Supe AN. TG13 surgical management of acute cholecystitis. J Hepatobiliary Pancreat Sci. 2013;20:89–96. doi: 10.1007/s00534-012-0567-x.
    1. Campanile FC, Catena F, Coccolini F, Lotti M, Piazzalunga D, Pisano M, Ansaloni L. The need for new “patient-related” guidelines for the treatment of acute cholecystitis. World J Emerg Surg. 2011;6:44. doi: 10.1186/1749-7922-6-44.
    1. Lai PB, Kwong KH, Leung KL, Kwok SP, Chan AC, Chung SC, Lau WY. Randomized trial of early versus delayed laparoscopic cholecystectomy for acute cholecystitis. Br J Surg. 1998;85:764–767. doi: 10.1046/j.1365-2168.1998.00708.x.
    1. Lo CM, Liu CL, Fan ST, Lai EC, Wong J. Prospective randomized study of early versus delayed laparoscopic cholecystectomy for acute cholecystitis. Ann Surg. 1998;227:461–467. doi: 10.1097/00000658-199804000-00001.
    1. Dàvila D, Manzanares C, Pichò ML, Albors P, Càrdenas F, Fuster E. Experience in the treatment (early vs delayed) of acute cholecystitis via laparoscopy. Cir Esp. 1999;66(suppl 1):233.
    1. Chandler CF, Lane JS, Ferguson P, Thompson JE, Ashley SW. Prospective evaluation of early versus delayed laparoscopic cholecystectomy for treatment of acute cholecystitis. Am Surg. 2000;66:896–900.
    1. Johansson M, Thune A, Blomqvist A, Nelvin L, Lundell L. Management of acute cholecystitis in the laparoscopic era: results of a prospective, randomized clinical trial. J Gastrointest Surg. 2003;7:642–645. doi: 10.1016/S1091-255X(03)00065-9.
    1. Kolla SB, Aggarwal S, Kumar A, Kumar R, Chumber S, Parshad R, Seenu V. Early versus delayed laparoscopic cholecystectomy for acute cholecystitis: a prospective randomized trial. Surg Endosc. 2004;18:1323–1327. doi: 10.1007/s00464-003-9230-6.
    1. Yadav RP, Adhikary S, Agrawal CS, Bhattarai B, Gupta RK, Ghimire A. A comparative study of early vs. delayed laparoscopic cholecystectomy in acute cholecystitis. Kathmandu Univ Med J (KUMJ) 2009;7(25):16.
    1. Papi C, Catarci M, D’Ambrosio L, Gili L, Koch M, Grassi GB, Capurso L. Timing of cholecystectomy for acute calculous cholecystitis: a meta-analysis. Am J Gastroenterol. 2004;99:147–155. doi: 10.1046/j.1572-0241.2003.04002.x.
    1. Shikata S, Noguchi Y, Fukui T. Early versus delayed cholecystectomy for acute cholecystitis: a meta-analysis of randomized controlled trials. Surg Today. 2005;35:553–560. doi: 10.1007/s00595-005-2998-3.
    1. Lau H, Lo CY, Patil NG, Yuen WK. Early versus delayed-interval laparoscopic cholecystectomy for acute cholecystitis: a metaanalysis. Surg Endosc. 2006;20:82–87. doi: 10.1007/s00464-005-0100-2.
    1. Gurusamy KS, Davidson C, Gluud C, Davidson BR. Early versus delayed laparoscopic cholecystectomy for people with acute cholecystitis. Cochrane Database Syst Rev. 2013;6:CD005440.
    1. Siddiqui T, MacDonald A, Chong PS, Jenkins JT. Early versus delayed laparoscopic cholecystectomy for acute cholecystitis: a meta-analysis of randomized clinical trials. Am J Surg. 2008;195:40–47. doi: 10.1016/j.amjsurg.2007.03.004.
    1. Gurusamy K, Samraj K, Gluud C, Wilson E, Davidson BR. Meta-analysis of randomized controlled trials on the safety and effectiveness of early versus delayed laparoscopic cholecystectomy for acute cholecystitis. Br J Surg. 2010;97:141–150. doi: 10.1002/bjs.6870.
    1. Banz V, Gsponer T, Candinas D, Güller U. Population-based analysis of 4113 patients with acute cholecystitis: defining the optimal time-point for laparoscopic cholecystectomy. Ann Surg. 2011;254:964–970. doi: 10.1097/SLA.0b013e318228d31c.
    1. Hirota M, Takada T, Kawarada Y, Nimura Y, Miura F, Hirata K, Mayumi T, Yoshida M, Strasberg S, Pitt H, Gadacz TR, Santibanes E d, Gouma DJ, Solomkin JS, Belghiti J, Neuhaus H, Büchler MW, Fan S-T, Ker C-G, Padbury RT, Liau K-H, Hilvano SC, Belli G, Windsor JA, Dervenis C. Diagnostic criteria and severity assessment of acute cholecystitis: Tokyo Guidelines. J Hepatobiliary Pancreat Surg. 2007;14:78–82. doi: 10.1007/s00534-006-1159-4.
    1. Mayumi T, Takada T, Kawarada Y, Nimura Y, Yoshida M, Sekimoto M, Miura F, Wada K, Hirota M, Yamashita Y, Nagino M, Tsuyuguchi T, Tanaka A, Gomi H, Pitt HA. Results of the Tokyo Consensus Meeting Tokyo Guidelines. J Hepatobiliary Pancreat Surg. 2007;14:114–121. doi: 10.1007/s00534-006-1163-8.
    1. Yokoe M, Takada T, Strasberg SM, Solomkin JS, Mayumi T, Gomi H, Pitt HA, Gouma DJ, Garden OJ, Büchler MW, Kiriyama S, Kimura Y, Tsuyuguchi T, Itoi T, Yoshida M, Miura F, Yamashita Y, Okamoto K, Gabata T, Hata J, Higuchi R, Windsor JA, Bornman PC, Fan S-T, Singh H, de Santibanes E, Kusachi S, Murata A, Chen X-P, Jagannath P, et al. New diagnostic criteria and severity assessment of acute cholecystitis in revised Tokyo Guidelines. J Hepatobiliary Pancreat Sci. 2012;19:578–585. doi: 10.1007/s00534-012-0548-0.
    1. Choi SB, Han HJ, Kim CY, Kim WB, Song T-J, Suh SO, Kim YC, Choi SY. Early laparoscopic cholecystectomy is the appropriate management for acute gangrenous cholecystitis. Am Surg. 2011;77:401–406.
    1. Lo H-C, Wang Y-C, Su L-T, Hsieh C-H. Can early laparoscopic cholecystectomy be the optimal management of cholecystitis with gallbladder perforation? A single institute experience of 74 cases. Surg Endosc. 2012;26:3301–3306. doi: 10.1007/s00464-012-2344-y.
    1. Nikfarjam M, Niumsawatt V, Sethu A, Fink MA, Muralidharan V, Starkey G, Jones RM, Christophi C. Outcomes of contemporary management of gangrenous and non-gangrenous acute cholecystitis. HPB (Oxford) 2011;13:551–558. doi: 10.1111/j.1477-2574.2011.00327.x.
    1. Riall TS, Zhang D, Townsend CM, Jr, Kuo YF, Goodwin JS. Failure to perform cholecystectomy for acute cholecystitis in elderly patients is associated with increased morbidity, mortality, and cost. J Am Coll Surg. 2010;210(5):668–679. doi: 10.1016/j.jamcollsurg.2009.12.031.
    1. Sánchez Beorlegui J, Lagunas Lostao E, Lamata Hernández F, Monsalve Laguna EC. Tratamiento de la colecistitis aguda en en el anciano: cirugía urgente frente a terapia médica y cirugía diferida. Rev Gastroenterol Peru. 2009;29(4):332–340.
    1. Lupinacci RM, Nadal LR, Rego RE, Dias AR, Marcari RS, Lupinacci RA, Farah JFM. Surgical management of gallbladder disease in the very elderly: are we operating them at the right time? Eur J Gastroenterol Hepatol. 2013;25:380–384. doi: 10.1097/MEG.0b013e32835b7124.
    1. Borzellino G, Sauerland S, Minicozzi AM, Verlato G, Di Pietrantonj C, de Manzoni G, Cordiano C. Laparoscopic cholecystectomy for severe acute cholecystitis. A meta-analysis of results. Surg Endosc. 2008;22:8–15. doi: 10.1007/s00464-007-9511-6.
    1. Kiviluoto T, Siren J, Luukkonen P, Kivilaakso E. Randomised trial of laparoscopic versus open cholecystectomy for acute and gangrenous cholecystitis. Lancet. 1998;351:321–325. doi: 10.1016/S0140-6736(97)08447-X.
    1. Johansson M, Thune A, Nelvin L, Stiernstam M, Westman B, Lundell L. Randomized clinical trial of open versus laparoscopic cholecystectomy in the treatment of acute cholecystitis. Br J Surg. 2005;92:44–49. doi: 10.1002/bjs.4836.
    1. Csikesz N, Ricciardi R, Tseng JF, Shah SA. Current status of surgical management of acute cholecystitis in the United States. World J Surg. 2008;32(10):2230–2236. doi: 10.1007/s00268-008-9679-5.
    1. Pessaux P, Regenet N, Tuech JJ, Rouge C, Bergamaschi R, Arnaud JP. Laparoscopic versus open cholecystectomy: A prospective comparative study in the elderly with acute cholecystitis. Surg Laparosc Endosc Percutan Tech. 2001;11(4):252–255. doi: 10.1097/00129689-200108000-00005.
    1. Lujan JA, Sanchez-Bueno F, Parrilla P, Robles R, Torralba JA, Gonzalez-Costea R. Laparoscopic vs. open cholecystectomy in patients aged 65 and older. Laparosc Endosc Percutan Tech. 1998;8(3):208–210. doi: 10.1097/00019509-199806000-00009.
    1. Chau CH, Tang CN, Siu WT, Ha JP, Li MK. Laparoscopic cholecystectomy versus open cholecystectomy in elderly patients with acute cholecystitis: retrospective study. Hong Kong Med. 2002;J8:394–399.
    1. Massie MT, Massie LB, Marrangoni AG, D’Amico FJ, Sell HW. Advantages of laparoscopic cholecystectomy in the elderly and in patients with high ASA classifications. J Laparoendosc Surg. 1993;3:467–476. doi: 10.1089/lps.1993.3.467.
    1. Gomi H, Solomkin JS, Takada T, Strasberg SM, Pitt HA, Yoshida M, Kusachi S, Mayumi T, Miura F, Kiriyama S, Yokoe M, Kimura Y, Higuchi R, Windsor JA, Dervenis C, Liau K-H, Kim M-H. Tokyo Guideline Revision Committee: TG13 antimicrobial therapy for acute cholangitis and cholecystitis. J Hepatobiliary Pancreat Sci. 2013;20:60–70. doi: 10.1007/s00534-012-0572-0.
    1. Sartelli M, Viale P, Catena F, Ansaloni L, Moore E, Malangoni M, Moore FA, Velmahos G, Coimbra R, Ivatury R, Peitzman A, Koike K, Leppaniemi A, Biffl W, Burlew CC, Balogh ZJ, Boffard K, Bendinelli C, Gupta S, Kluger Y, Agresta F, Di Saverio S, Wani I, Escalona A, Ordonez C, Fraga GP, Junior GAP, Bala M, Cui Y, Marwah S, et al. 2013 WSES guidelines for management of intra-abdominal infections. World J Emerg Surg. 2013;8:3. doi: 10.1186/1749-7922-8-3.
    1. Gurusamy KS, Rossi M, Davidson BR. Percutaneous cholecystostomy for high-risk surgical patients with acute calculous cholecystitis. Cochrane Database Syst Rev. 2013;8:CD007088.
    1. Winbladh A, Gullstrand P, Svanvik J, Sandström P. Systematic review of cholecystostomy as a treatment option in acute cholecystitis. HPB (Oxford) 2009;11(3):183–193. doi: 10.1111/j.1477-2574.2009.00052.x.
    1. Kortram K, van Ramshorst B, Bollen TL, Besselink MGH, Gouma DJ, Karsten T, Kruyt PM, Nieuwenhuijzen GAP, Kelder JC, Tromp E, Boerma D. Acute cholecystitis in high risk surgical patients: percutaneous cholecystostomy versus laparoscopic cholecystectomy (CHOCOLATE trial): study protocol for a randomized controlled trial. Trials. 2012;13:7. doi: 10.1186/1745-6215-13-7.
    1. Lee S-W, Yang S-S, Chang C-S, Yeh H-J. Impact of the Tokyo guidelines on the management of patients with acute calculous cholecystitis. J Gastroenterol Hepatol. 2009;24:1857–1861. doi: 10.1111/j.1440-1746.2009.05923.x.
    1. Rix TE, Bates T. Pre-operative risk scores for the prediction of outcome in elderly people who require emergency surgery. World J Emerg Surg. 2007;2:16. doi: 10.1186/1749-7922-2-16.
    1. Vaid S, Bell T, Grim R, Ahuja V. Predicting risk of death in general surgery patients on the basis of preoperative variables using American College of Surgeons National Surgical Quality Improvement Program data. Perm J. 2012;16:10–17. doi: 10.7812/TPP/12-019.
    1. Asai K, Watanabe M, Kusachi S, Matsukiyo H, Saito T, Kodama H, Dotai K, Hagiwara O, Enomoto T, Nakamura Y, Okamoto Y, Saida Y, Nagao J. Changes in the therapeutic strategy for acute cholecystitis after the Tokyo guidelines were published. J Hepatobiliary Pancreat Sci. 2013;20:348–355. doi: 10.1007/s00534-012-0536-4.
    1. Afuwape OO, Akute OO. The challenges and solutions of laparoscopic surgical practice in the developing countries. Niger Postgrad Med J. 2011;18:197–199.
    1. Manning RG, Aziz AQ. Should laparoscopic cholecystectomy be practiced in the developing world?: the experience of the first training program in Afghanistan. Ann Surg. 2009;249:794–798. doi: 10.1097/SLA.0b013e3181a3eaa9.
    1. Teerawattananon Y, Mugford M : Is it worth offering a routine laparoscopic cholecystectomy in developing countries? A Thailand case study. Cost Eff Resour Alloc. 2005;3:10. doi: 10.1186/1478-7547-3-10.

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