Long-term follow up of non-operative management in acute cholecystitis.
EAES Academy. Leiberman C. 07/05/22; 363033; P077
Dr. Christopher Leiberman
Contributions
Contributions
Abstract
Aim:
To observe the long-term impact of conservative management on patients admitted with acute cholecystitis.
Background:
Surgery is currently the recommended treatment for acute cholecystitis and the WSES recommend that emergency laparoscopic cholecystectomy be performed as soon as possible. However, given the impact of the COVID-19 pandemic on healthcare delivery, this is not always possible. So, what happens to those who are managed conservatively?
Methods:
Twenty-eight patients were admitted with acute cholecystitis to a large tertiary hospital in November 2020; twenty-three were discharged without having had a cholecystectomy. These patients were followed up for one year and observed for the development of any gallstone-related admissions and surgical procedures.
Results:
Of the 23 patients observed, 30% (n=7) were admitted for gallstone-related complications. Biliary colic was responsible for 43% of these admissions with pancreatitis (14%), cholangitis (14%), choledocholithiasis (14%), and cholecystitis (14%) causing the rest. Only 9% (n=2) received a laparoscopic cholecystectomy. In both cases it was in an emergency setting during an admission for biliary colic.
Conclusion:
Long-term observation of conservatively managed acute cholecystitis was possible in around two-thirds of patients as no gallstone-related hospital admissions were observed. Biliary colic was the most common cause gallstone-related admissions. Longer observation is required to assess the feasibility of long-term non-operative management in acute cholecystitis.
To observe the long-term impact of conservative management on patients admitted with acute cholecystitis.
Background:
Surgery is currently the recommended treatment for acute cholecystitis and the WSES recommend that emergency laparoscopic cholecystectomy be performed as soon as possible. However, given the impact of the COVID-19 pandemic on healthcare delivery, this is not always possible. So, what happens to those who are managed conservatively?
Methods:
Twenty-eight patients were admitted with acute cholecystitis to a large tertiary hospital in November 2020; twenty-three were discharged without having had a cholecystectomy. These patients were followed up for one year and observed for the development of any gallstone-related admissions and surgical procedures.
Results:
Of the 23 patients observed, 30% (n=7) were admitted for gallstone-related complications. Biliary colic was responsible for 43% of these admissions with pancreatitis (14%), cholangitis (14%), choledocholithiasis (14%), and cholecystitis (14%) causing the rest. Only 9% (n=2) received a laparoscopic cholecystectomy. In both cases it was in an emergency setting during an admission for biliary colic.
Conclusion:
Long-term observation of conservatively managed acute cholecystitis was possible in around two-thirds of patients as no gallstone-related hospital admissions were observed. Biliary colic was the most common cause gallstone-related admissions. Longer observation is required to assess the feasibility of long-term non-operative management in acute cholecystitis.
Aim:
To observe the long-term impact of conservative management on patients admitted with acute cholecystitis.
Background:
Surgery is currently the recommended treatment for acute cholecystitis and the WSES recommend that emergency laparoscopic cholecystectomy be performed as soon as possible. However, given the impact of the COVID-19 pandemic on healthcare delivery, this is not always possible. So, what happens to those who are managed conservatively?
Methods:
Twenty-eight patients were admitted with acute cholecystitis to a large tertiary hospital in November 2020; twenty-three were discharged without having had a cholecystectomy. These patients were followed up for one year and observed for the development of any gallstone-related admissions and surgical procedures.
Results:
Of the 23 patients observed, 30% (n=7) were admitted for gallstone-related complications. Biliary colic was responsible for 43% of these admissions with pancreatitis (14%), cholangitis (14%), choledocholithiasis (14%), and cholecystitis (14%) causing the rest. Only 9% (n=2) received a laparoscopic cholecystectomy. In both cases it was in an emergency setting during an admission for biliary colic.
Conclusion:
Long-term observation of conservatively managed acute cholecystitis was possible in around two-thirds of patients as no gallstone-related hospital admissions were observed. Biliary colic was the most common cause gallstone-related admissions. Longer observation is required to assess the feasibility of long-term non-operative management in acute cholecystitis.
To observe the long-term impact of conservative management on patients admitted with acute cholecystitis.
Background:
Surgery is currently the recommended treatment for acute cholecystitis and the WSES recommend that emergency laparoscopic cholecystectomy be performed as soon as possible. However, given the impact of the COVID-19 pandemic on healthcare delivery, this is not always possible. So, what happens to those who are managed conservatively?
Methods:
Twenty-eight patients were admitted with acute cholecystitis to a large tertiary hospital in November 2020; twenty-three were discharged without having had a cholecystectomy. These patients were followed up for one year and observed for the development of any gallstone-related admissions and surgical procedures.
Results:
Of the 23 patients observed, 30% (n=7) were admitted for gallstone-related complications. Biliary colic was responsible for 43% of these admissions with pancreatitis (14%), cholangitis (14%), choledocholithiasis (14%), and cholecystitis (14%) causing the rest. Only 9% (n=2) received a laparoscopic cholecystectomy. In both cases it was in an emergency setting during an admission for biliary colic.
Conclusion:
Long-term observation of conservatively managed acute cholecystitis was possible in around two-thirds of patients as no gallstone-related hospital admissions were observed. Biliary colic was the most common cause gallstone-related admissions. Longer observation is required to assess the feasibility of long-term non-operative management in acute cholecystitis.
{{ help_message }}
{{filter}}