The severity grading of acute cholecystitis following the Tokyo Guidelines is the most powerful predictive factor for conversion from laparoscopic cholecystectomy to open cholecystectomy
The relationship between the severity assessment of acute cholecystitis based on the Tokyo Guidelines and the risk for conversion from laparoscopic surgery to open surgery has been assessed in few previous reports, with conflicting results. A retrospective review of patients with acute cholecystitis...
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| Veröffentlicht in: | Journal of visceral surgery Jg. 154; H. 4; S. 239 - 243 |
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Elsevier Masson SAS
01.09.2017
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| Abstract | The relationship between the severity assessment of acute cholecystitis based on the Tokyo Guidelines and the risk for conversion from laparoscopic surgery to open surgery has been assessed in few previous reports, with conflicting results.
A retrospective review of patients with acute cholecystitis within a single system from 2010 to 2013 was performed. The diagnosis and severity of acute cholecystitis were assigned by the Tokyo Guidelines 2013 (TG13). The primary outcome measure was conversion to open cholecystectomy.
During the period of study, 493 patients were operated by laparoscopy for acute cholecystitis. Laparoscopic cholecystectomy was intraoperatively converted to open surgery in 56 cases (11.4%). The multivariate analysis showed that the risk factors for conversion to open surgery included male gender (OR: 2.15; IC95% [1.18–3.9]), diabetes (OR: 2.22; IC95% [1.13–4.33]), total bilirubin levels (OR: 1.02; IC95% [1–1.05]), and the TG13 severity classification (OR: 4.44; IC95% [2.25–8.75]).
The independent risk factors for conversion to open surgery included male sex, diabetes mellitus, total bilirubin level, and TG13 grade. TG13 grade was found to be the most powerful predictive factor for conversion as it had the highest OR. |
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| AbstractList | The relationship between the severity assessment of acute cholecystitis based on the Tokyo Guidelines and the risk for conversion from laparoscopic surgery to open surgery has been assessed in few previous reports, with conflicting results.BACKGROUNDThe relationship between the severity assessment of acute cholecystitis based on the Tokyo Guidelines and the risk for conversion from laparoscopic surgery to open surgery has been assessed in few previous reports, with conflicting results.A retrospective review of patients with acute cholecystitis within a single system from 2010 to 2013 was performed. The diagnosis and severity of acute cholecystitis were assigned by the Tokyo Guidelines 2013 (TG13). The primary outcome measure was conversion to open cholecystectomy.METHODSA retrospective review of patients with acute cholecystitis within a single system from 2010 to 2013 was performed. The diagnosis and severity of acute cholecystitis were assigned by the Tokyo Guidelines 2013 (TG13). The primary outcome measure was conversion to open cholecystectomy.During the period of study, 493 patients were operated by laparoscopy for acute cholecystitis. Laparoscopic cholecystectomy was intraoperatively converted to open surgery in 56 cases (11.4%). The multivariate analysis showed that the risk factors for conversion to open surgery included male gender (OR: 2.15; IC95% [1.18-3.9]), diabetes (OR: 2.22; IC95% [1.13-4.33]), total bilirubin levels (OR: 1.02; IC95% [1-1.05]), and the TG13 severity classification (OR: 4.44; IC95% [2.25-8.75]).RESULTSDuring the period of study, 493 patients were operated by laparoscopy for acute cholecystitis. Laparoscopic cholecystectomy was intraoperatively converted to open surgery in 56 cases (11.4%). The multivariate analysis showed that the risk factors for conversion to open surgery included male gender (OR: 2.15; IC95% [1.18-3.9]), diabetes (OR: 2.22; IC95% [1.13-4.33]), total bilirubin levels (OR: 1.02; IC95% [1-1.05]), and the TG13 severity classification (OR: 4.44; IC95% [2.25-8.75]).The independent risk factors for conversion to open surgery included male sex, diabetes mellitus, total bilirubin level, and TG13 grade. TG13 grade was found to be the most powerful predictive factor for conversion as it had the highest OR.CONCLUSIONSThe independent risk factors for conversion to open surgery included male sex, diabetes mellitus, total bilirubin level, and TG13 grade. TG13 grade was found to be the most powerful predictive factor for conversion as it had the highest OR. The relationship between the severity assessment of acute cholecystitis based on the Tokyo Guidelines and the risk for conversion from laparoscopic surgery to open surgery has been assessed in few previous reports, with conflicting results. A retrospective review of patients with acute cholecystitis within a single system from 2010 to 2013 was performed. The diagnosis and severity of acute cholecystitis were assigned by the Tokyo Guidelines 2013 (TG13). The primary outcome measure was conversion to open cholecystectomy. During the period of study, 493 patients were operated by laparoscopy for acute cholecystitis. Laparoscopic cholecystectomy was intraoperatively converted to open surgery in 56 cases (11.4%). The multivariate analysis showed that the risk factors for conversion to open surgery included male gender (OR: 2.15; IC [1.18-3.9]), diabetes (OR: 2.22; IC [1.13-4.33]), total bilirubin levels (OR: 1.02; IC [1-1.05]), and the TG13 severity classification (OR: 4.44; IC [2.25-8.75]). The independent risk factors for conversion to open surgery included male sex, diabetes mellitus, total bilirubin level, and TG13 grade. TG13 grade was found to be the most powerful predictive factor for conversion as it had the highest OR. The relationship between the severity assessment of acute cholecystitis based on the Tokyo Guidelines and the risk for conversion from laparoscopic surgery to open surgery has been assessed in few previous reports, with conflicting results. A retrospective review of patients with acute cholecystitis within a single system from 2010 to 2013 was performed. The diagnosis and severity of acute cholecystitis were assigned by the Tokyo Guidelines 2013 (TG13). The primary outcome measure was conversion to open cholecystectomy. During the period of study, 493 patients were operated by laparoscopy for acute cholecystitis. Laparoscopic cholecystectomy was intraoperatively converted to open surgery in 56 cases (11.4%). The multivariate analysis showed that the risk factors for conversion to open surgery included male gender (OR: 2.15; IC95% [1.18–3.9]), diabetes (OR: 2.22; IC95% [1.13–4.33]), total bilirubin levels (OR: 1.02; IC95% [1–1.05]), and the TG13 severity classification (OR: 4.44; IC95% [2.25–8.75]). The independent risk factors for conversion to open surgery included male sex, diabetes mellitus, total bilirubin level, and TG13 grade. TG13 grade was found to be the most powerful predictive factor for conversion as it had the highest OR. |
| Author | Chtourou, M.F. Touinsi, H. Hamzaoui, L. Bouassida, M. Charrada, H. Zribi, S. Mighri, M.M. |
| Author_xml | – sequence: 1 givenname: M. surname: Bouassida fullname: Bouassida, M. email: bouassidamahdi@yahoo.fr organization: Department of Surgery, Mohamed Tahar Maamouri Hospital, 8000 Nabeul, Tunisia – sequence: 2 givenname: M.F. surname: Chtourou fullname: Chtourou, M.F. organization: Department of Surgery, Mohamed Tahar Maamouri Hospital, 8000 Nabeul, Tunisia – sequence: 3 givenname: H. surname: Charrada fullname: Charrada, H. organization: Department of Surgery, Mohamed Tahar Maamouri Hospital, 8000 Nabeul, Tunisia – sequence: 4 givenname: S. surname: Zribi fullname: Zribi, S. organization: Department of Surgery, Mohamed Tahar Maamouri Hospital, 8000 Nabeul, Tunisia – sequence: 5 givenname: L. surname: Hamzaoui fullname: Hamzaoui, L. organization: Department of Gastroenterology, Mohamed Tahar Maamouri Hospital, 8000 Nabeul, Tunisia – sequence: 6 givenname: M.M. surname: Mighri fullname: Mighri, M.M. organization: Department of Surgery, Mohamed Tahar Maamouri Hospital, 8000 Nabeul, Tunisia – sequence: 7 givenname: H. surname: Touinsi fullname: Touinsi, H. organization: Department of Surgery, Mohamed Tahar Maamouri Hospital, 8000 Nabeul, Tunisia |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/28709978$$D View this record in MEDLINE/PubMed |
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| Keywords | Conversion Acute cholecystitis Laparoscopy |
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| Title | The severity grading of acute cholecystitis following the Tokyo Guidelines is the most powerful predictive factor for conversion from laparoscopic cholecystectomy to open cholecystectomy |
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