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Published in: Surgical Endoscopy 10/2022

21-03-2022 | Cholecystitis

Timing of cholecystectomy following cholecystostomy tube placement for acute cholecystitis: a retrospective study aiming to identify the optimal timing between a percutaneous cholecystostomy and cholecystectomy to reduce the number of poor surgical outcomes

Authors: Caroline Polito, Xiaoyue Zhang, Jie Yang, Konstantinos Spaniolas, Aurora Pryor, Samer Sbayi

Published in: Surgical Endoscopy | Issue 10/2022

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Abstract

Objective

Our study aims to identify the optimal timing between a percutaneous cholecystostomy (PC) and cholecystectomy to reduce the number of poor surgical outcomes.

Background

Biliary disease is a common surgical disease and laparoscopic cholecystectomy is the preferred strategy for the management of acute cholecystitis. However, in high-risk surgical patients, a PC tube may be placed instead. In the 2018 Tokyo Guidelines, the optimal timing of cholecystectomy following a PC has been identified as an important future research question.

Methods

This is a retrospective study that focuses on identifying the ideal timing of cholecystectomy after PC tube placement to minimize complications. Poor surgical outcomes were measured as 90-day reoperations, 30-day readmissions, 30-day emergency department (ED) visits, length of stay (LOS), and discharge destination. Patients were selected from the New York SPARCS database from 2005 to September 30, 2015.

Results

1213 records that consisted of both PC and cholecystectomy were collected. No significant differences in 30-day readmissions, 90-day reoperations, and 30-day ED visits in relation to timing between PC and cholecystectomy were found. Additionally, the decision to replace or not replace dislodged PC tubes was not associated with 90-day reoperation, 30-day readmission, 30-day ED visit, LOS, or discharge destination. However, discharge destination and LOS were significantly different between early intervention of 3 days or less between PC and cholecystectomy and late intervention of more than 14 days with late intervention being associated with shorter LOS and more home discharges.

Conclusion

Performing a cholecystectomy more than 14 days after a PC is associated with better surgical outcomes.
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Metadata
Title
Timing of cholecystectomy following cholecystostomy tube placement for acute cholecystitis: a retrospective study aiming to identify the optimal timing between a percutaneous cholecystostomy and cholecystectomy to reduce the number of poor surgical outcomes
Authors
Caroline Polito
Xiaoyue Zhang
Jie Yang
Konstantinos Spaniolas
Aurora Pryor
Samer Sbayi
Publication date
21-03-2022
Publisher
Springer US
Published in
Surgical Endoscopy / Issue 10/2022
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI
https://doi.org/10.1007/s00464-022-09193-y

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