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Acute calculous cholecystitis: Review of current best practices
Acute calculous cholecystitis (ACC) is the most frequent complication of cholelithiasis and represents one-third of all surgical emergency hospital admissions, many aspects of the disease are still a matter of debate. Knowledge of the current evidence may allow the surgical team to develop practical...
Autores principales: | , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Baishideng Publishing Group Inc
2017
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5442405/ https://www.ncbi.nlm.nih.gov/pubmed/28603584 http://dx.doi.org/10.4240/wjgs.v9.i5.118 |
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author | Gomes, Carlos Augusto Junior, Cleber Soares Di Saveiro, Salomone Sartelli, Massimo Kelly, Michael Denis Gomes, Camila Couto Gomes, Felipe Couto Corrêa, Lívia Dornellas Alves, Camila Brandão Guimarães, Samuel de Fádel |
author_facet | Gomes, Carlos Augusto Junior, Cleber Soares Di Saveiro, Salomone Sartelli, Massimo Kelly, Michael Denis Gomes, Camila Couto Gomes, Felipe Couto Corrêa, Lívia Dornellas Alves, Camila Brandão Guimarães, Samuel de Fádel |
author_sort | Gomes, Carlos Augusto |
collection | PubMed |
description | Acute calculous cholecystitis (ACC) is the most frequent complication of cholelithiasis and represents one-third of all surgical emergency hospital admissions, many aspects of the disease are still a matter of debate. Knowledge of the current evidence may allow the surgical team to develop practical bedside decision-making strategies, aiming at a less demanding procedure and lower frequency of complications. In this regard, recommendations on the diagnosis supported by specific criteria and severity scores are being implemented, to prioritize patients eligible for urgency surgery. Laparoscopic cholecystectomy is the best treatment for ACC and the procedure should ideally be performed within 72 h. Early surgery is associated with better results in comparison to delayed surgery. In addition, when to suspect associated common bile duct stones and how to treat them when found are still debated. The antimicrobial agents are indicated for high-risk patients and especially in the presence of gallbladder necrosis. The use of broad-spectrum antibiotics and in some cases with antifungal agents is related to better prognosis. Moreover, an emerging strategy of not converting to open, a difficult laparoscopic cholecystectomy and performing a subtotal cholecystectomy is recommended by adept surgical teams. Some authors support the use of percutaneous cholecystostomy as an alternative emergency treatment for acute Cholecystitis for patients with severe comorbidities. |
format | Online Article Text |
id | pubmed-5442405 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | Baishideng Publishing Group Inc |
record_format | MEDLINE/PubMed |
spelling | pubmed-54424052017-06-10 Acute calculous cholecystitis: Review of current best practices Gomes, Carlos Augusto Junior, Cleber Soares Di Saveiro, Salomone Sartelli, Massimo Kelly, Michael Denis Gomes, Camila Couto Gomes, Felipe Couto Corrêa, Lívia Dornellas Alves, Camila Brandão Guimarães, Samuel de Fádel World J Gastrointest Surg Minireviews Acute calculous cholecystitis (ACC) is the most frequent complication of cholelithiasis and represents one-third of all surgical emergency hospital admissions, many aspects of the disease are still a matter of debate. Knowledge of the current evidence may allow the surgical team to develop practical bedside decision-making strategies, aiming at a less demanding procedure and lower frequency of complications. In this regard, recommendations on the diagnosis supported by specific criteria and severity scores are being implemented, to prioritize patients eligible for urgency surgery. Laparoscopic cholecystectomy is the best treatment for ACC and the procedure should ideally be performed within 72 h. Early surgery is associated with better results in comparison to delayed surgery. In addition, when to suspect associated common bile duct stones and how to treat them when found are still debated. The antimicrobial agents are indicated for high-risk patients and especially in the presence of gallbladder necrosis. The use of broad-spectrum antibiotics and in some cases with antifungal agents is related to better prognosis. Moreover, an emerging strategy of not converting to open, a difficult laparoscopic cholecystectomy and performing a subtotal cholecystectomy is recommended by adept surgical teams. Some authors support the use of percutaneous cholecystostomy as an alternative emergency treatment for acute Cholecystitis for patients with severe comorbidities. Baishideng Publishing Group Inc 2017-05-27 2017-05-27 /pmc/articles/PMC5442405/ /pubmed/28603584 http://dx.doi.org/10.4240/wjgs.v9.i5.118 Text en ©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved. http://creativecommons.org/licenses/by-nc/4.0/ Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ |
spellingShingle | Minireviews Gomes, Carlos Augusto Junior, Cleber Soares Di Saveiro, Salomone Sartelli, Massimo Kelly, Michael Denis Gomes, Camila Couto Gomes, Felipe Couto Corrêa, Lívia Dornellas Alves, Camila Brandão Guimarães, Samuel de Fádel Acute calculous cholecystitis: Review of current best practices |
title | Acute calculous cholecystitis: Review of current best practices |
title_full | Acute calculous cholecystitis: Review of current best practices |
title_fullStr | Acute calculous cholecystitis: Review of current best practices |
title_full_unstemmed | Acute calculous cholecystitis: Review of current best practices |
title_short | Acute calculous cholecystitis: Review of current best practices |
title_sort | acute calculous cholecystitis: review of current best practices |
topic | Minireviews |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5442405/ https://www.ncbi.nlm.nih.gov/pubmed/28603584 http://dx.doi.org/10.4240/wjgs.v9.i5.118 |
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