Optimal timing of laparoscopic cholecystectomy after gallbladder drainage for acute cholecystitis: A multi‐institutional retrospective study. (21st June 2020)

• Record Type: Journal Article
• Authors: Tomimaru, Yoshito; Fukuchi, Nariaki; Yokoyama, Shigekazu; Mori, Takuji; Tanemura, Masahiro; Sakai, Kenji; Takeda, Yutaka; Tsujie, Masanori; Yamada, Terumasa; Miyamoto, Atsushi; Hashimoto, Yasuji; Hatano, Hisanori; Shimizu, Junzo; Sugimoto, Keishi; Kashiwazaki, Masaki; Kobayashi, Shogo; Doki, Yuichiro; Eguchi, Hidetoshi
• Is Part Of: Journal of hepato-biliary-pancreatic sciences. Volume 27:Number 8(2020)
• Page Start: 451
• Page End: 460
• Publication Date: 2020-06-21
• Subjects: acute cholecystitis -- gallbladder drainage -- laparoscopic cholecystectomy -- outcome -- timing; Liver -- Diseases -- Periodicals; Biliary tract -- Diseases -- Periodicals; Pancreas -- Diseases -- Periodicals; 617.556
• DOI: 10.1002/jhbp.768
• Languages: English
• ISSNs: 1868-6974

Abstract

Abstract: Background: There is no consensus on the optimal timing of laparoscopic cholecystectomy (LC) after gallbladder drainage for acute cholecystitis (AC). To obtain evidence for a consensus, we investigated surgical outcomes of LC after gallbladder drainage with respect to the time elapsed from gallbladder drainage to surgery in a multi‐institutional retrospective study. Methods: This study enrolled 347 patients who underwent LC after gallbladder drainage for AC at 15 institutions. Surgical outcome of LC was investigated in the cases based on the interval from gallbladder drainage to surgery. Results: The median interval from gallbladder drainage to surgery of the patients was 34 days, with a mean ± standard deviation of 58 ± 99 days. Patients were divided into four groups based on quartiles of the interval: Group A, cases with an interval of 1‐12 days; Group B, cases with an interval of 13‐34 days; Group C, cases with an interval of 35‐73 days; and Group D, cases with an interval of ≥74 days. Surgical outcomes, which were evaluated with respect to intraoperative blood loss, operation time, postoperative hospital stay, rate of intraoperative accident, conversion from laparoscopic to open surgery, and postoperative complication, were worse in Group B than in the other groups. The finding was verified by propensity score‐matched analysis. Conclusions: Surgical outcome of LC after gallbladder drainage for AC was inferior in Group B compared with the other groups. This finding could be useful for determining the optimal timing of LC after gallbladder drainage for AC. Abstract : Highlight In this multi‐institutional study, Tomimaru and colleagues investigated surgical outcomes of laparoscopic cholecystectomy after gallbladder drainage with respect to the interval between drainage and cholecystectomy. Outcomes were poorer for intervals of 13–34 days than for shorter or longer intervals. These findings may be useful in determining the optimal timing.