Cholécystite aiguë

We included two trials with 156 participants for this review. .. There was no significant difference in mortality between the two intervention groups ... There was no significant difference in overall morbidity between the two intervention groups ... Based on the current available evidence from randomised clinical trials, we are unable to determine the role of percutaneous cholecystostomy in the clinical management of high-risk surgical patients with acute cholecystitis. There is a need for adequately power

.. six trials provided data for the meta-analyses. A total of 488 participants .. We found no significant difference between early and late laparoscopic cholecystectomy on our primary outcomes. However, trials with high risk of bias indicate that early laparoscopic cholecystectomy during acute cholecystitis seems safe and may shorten the total hospital stay

We evaluate demographics and outcomes of percutaneous cholecystostomy in routine clinical practice in a population-based cohort [of 149 patients]. .. since only a half of the patients eventually received definitive surgical treatment, a better routine decision-making based on proper criteria may enable an improved allocation of the individual patient for tailored treatment according to the disease severity, [and] the patient's comorbidity burden

Critical parts of the bundles in TG18 include the diagnostic process, severity assessment, transfer of patients if necessary, and therapeutic approach at each time point. Observance of these items and procedures should improve the prognosis of acute cholangitis and cholecystitis

We propose a new flowchart for the treatment of acute cholecystitis (AC) in the Tokyo Guidelines 2018 (TG18). ... TG18 proposes that some Grade III AC can be treated by Lap-C ... For Grade II AC, if patients meet the criteria of CCI ≤5 and ASA-PS ≤2, TG18 recommends early Lap-C performed by experienced surgeons; and if not, after medical treatment and/or gallbladder drainage