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cholecystitis guidelines

Peter C Ambe, Sarantos Kaptanis, Marios Papadakis, Sebastian A Weber, Stefan Jansen, Hubert Zirngibl
BACKGROUND: Besides cholecystectomy (CC), percutaneous cholecystostomy (PC) has been recommended for the management of critically ill patients with acute cholecystitis. However, solid evidence on the benefit of PC in this subgroup of patients is lacking. METHODS: In accordance with the PRISMA guidelines for systematic reviews, we systematically searched the Cochrane Library, CINAHL, MEDLINE, Embase, and Scopus for relevant studies published between 2000 and 2014...
August 22, 2016: Deutsches Ärzteblatt International
K Naidu, E Beenen, S Gananadha, C Mosse
BACKGROUND: Each year, 1-4 % of people with known gallstones become symptomatic, either presenting with biliary colic or as acute cholecystitis. The distinction between both diagnoses remains challenging. To aid the proper diagnosis, the revised 2013 Tokyo Guidelines (TG 2013) were proposed with a self-acclaimed diagnostic accuracy of over 90 %. However, this accuracy has not been verified by others so far. OBJECTIVE: To determine the accuracy of the TG 2013 guidelines in the diagnosis of acute cholecystitis both in its single components of fever, inflammatory markers and US features and of the combined application of the TG 2013 guidelines as a whole...
July 26, 2016: World Journal of Surgery
Prabhava Bagla, Juan C Sarria, Taylor S Riall
PURPOSE OF REVIEW: Various aspects of the management of acute calculous cholecystitis, including type and timing of surgery, role of antibiotics, and nonoperative management, remain controversial. This review focuses on recently published studies addressing the timing of cholecystectomy, use of cholecystostomy tubes, and role of antibiotics in this condition. RECENT FINDINGS: In most cases, the diagnosis of acute cholecystitis can be initially confirmed with an abdominal ultrasound...
October 2016: Current Opinion in Infectious Diseases
L Ansaloni, M Pisano, F Coccolini, A B Peitzmann, A Fingerhut, F Catena, F Agresta, A Allegri, I Bailey, Z J Balogh, C Bendinelli, W Biffl, L Bonavina, G Borzellino, F Brunetti, C C Burlew, G Camapanelli, F C Campanile, M Ceresoli, O Chiara, I Civil, R Coimbra, M De Moya, S Di Saverio, G P Fraga, S Gupta, J Kashuk, M D Kelly, V Koka, H Jeekel, R Latifi, A Leppaniemi, R V Maier, I Marzi, F Moore, D Piazzalunga, B Sakakushev, M Sartelli, T Scalea, P F Stahel, K Taviloglu, G Tugnoli, S Uraneus, G C Velmahos, I Wani, D G Weber, P Viale, M Sugrue, R Ivatury, Y Kluger, K S Gurusamy, E E Moore
Acute calculus cholecystitis is a very common disease with several area of uncertainty. The World Society of Emergency Surgery developed extensive guidelines in order to cover grey areas. The diagnostic criteria, the antimicrobial therapy, the evaluation of associated common bile duct stones, the identification of "high risk" patients, the surgical timing, the type of surgery, and the alternatives to surgery are discussed. Moreover the algorithm is proposed: as soon as diagnosis is made and after the evaluation of choledocholitiasis risk, laparoscopic cholecystectomy should be offered to all patients exception of those with high risk of morbidity or mortality...
2016: World Journal of Emergency Surgery: WJES
Sung Gon Kim, Ju Ik Moon, In Seok Choi, Sang Eok Lee, Nak Song Sung, Ki Won Chun, Hye Yoon Lee, Dae Sung Yoon, Won Jun Choi
PURPOSE: The aim of this study was to investigate the risk factors for conversion to conventional laparoscopic cholecystectomy (CLC) in single incision laparoscopic cholecystectomy (SILC) along with the proposal for procedure selection guidelines in treating patients with benign gallbladder (GB) diseases. METHODS: SILC was performed in 697 cases between April 2010 and July 2014. Seventeen cases (2.4%) underwent conversion to conventional LC. We compared these 2 groups and analyzed the risk factors for conversion to CLC...
June 2016: Annals of Surgical Treatment and Research
Aoi Hayasaki, Koji Takahashi, Takehiro Fujii, Koji Kumamoto, Koji Fujii, Eiichi Matsumoto, Shigeki Miyahara, Tsukasa Kusuta, Yoshinori Azumi, Shuji Isaji
Purpose. To identify significant independent preoperative factors influencing postoperative hospital stay (PHS) and medical costs (MC) in 171 patients who underwent cholecystectomy for benign gallbladder diseases and had definite, suspected, or unmatched acute cholecystitis (AC) diagnosis according to the Tokyo Guidelines 2013 (TG13). Methods. The 171 patients were classified according to the combination of diagnostic criteria including local signs of inflammation (A), systemic signs of inflammation (B), and imaging findings (C): A+ B+ C (definite diagnosis, n = 84), A+ B (suspected diagnosis, n = 25), (A or B) + C (n = 10), A (n = 41), and B (n = 11)...
2016: Gastroenterology Research and Practice
A Yu Usenko, V G Yareshko, M E Nichitaylo, Yu A Mikheyev, S A Andreyeshchev
Basing on analysis of the multicenter clinical investigations results, as well as meta-analysis and consensuses, the main suggestions of the updated Tokyo's clinical recommendations for the treatment of an acute cholangitis and an acute cholecystitis (TG13), diagnostic criteria and the scales of estimation for the patients' state severity, were elaborated. Indications and the drainage methods of a gallbladder were substantiated - in an acute cholecystitis, and of biliary ducts - in an acute cholangitis, as well as peculiarities of surgical treatment of an acute cholecystitis...
October 2015: Klinichna Khirurhiia
Jin Zhou, Yunliang Wang, Xingguo Zhu, Dechun Li
Compared with distal gastrectomy, pylorus-preserving gastrectomy is less invasive which can decrease incidence of dumping syndrome, diarrhea and body weight lost, cholecystitis and gallstone, reflux gastritis and esophagitis and remnant gastric cancer. Based on new Japanese Gastric Cancer Treatment Guideline and new progression in the world, we give a review mainly basic characteristics, indications, operation details and short- and long-time outcomes after pylorus-preserving gastrectomy.
February 2016: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
H M Parretti, S A Jebb, D J Johns, A L Lewis, A M Christian-Brown, P Aveyard
Guidelines suggest that very-low-energy diets (VLEDs) should be used to treat obesity only when rapid weight loss is clinically indicated because of concerns about rapid weight regain. Literature databases were searched from inception to November 2014. Randomized trials were included where the intervention included a VLED and the comparator was no intervention or an intervention that could be given in a general medical setting in adults that were overweight. Two reviewers characterized the population, intervention, control groups, outcomes and appraised quality...
March 2016: Obesity Reviews: An Official Journal of the International Association for the Study of Obesity
Sriram Pothapregada, Banupriya Kamalakannan, Mahalakshmy Thulasingam
OBJECTIVES: To study the clinical profile and outcome of the atypical manifestations of dengue fever in children. METHODS: All children (0-12 y of age) diagnosed and confirmed as dengue fever at a tertiary care hospital at Puducherry, between the 1st of August 2012 and January 31st 2015 were reviewed retrospectively from hospital case records as per the revised World Health Organization (WHO) guidelines 2011 for dengue fever. The diagnosis was confirmed by NS1 antigen-based ELISA test or dengue serology for IgM and IgG antibodies and the data was analyzed using SPSS 16...
June 2016: Indian Journal of Pediatrics
Taro Ikumoto, Hidetsugu Yamagishi, Mineo Iwatate, Yasushi Sano, Masahito Kotaka, Yasuo Imai
AIM: To assess the safety of single-incision laparoscopic cholecystectomy (SILC) for acute cholecystitis. METHODS: All patients who underwent SILC at Sano Hospital (Kobe, Japan) between January 2010 and December 2014 were included in this retrospective study. Clinical data related to patient characteristics and surgical outcomes were collected from medical records. The parameters for assessing the safety of the procedure included operative time, volume of blood loss, achievement of the critical view of safety, use of additional trocars, conversion to laparotomy, intraoperative and postoperative complications, and duration of postoperative hospital stay...
December 25, 2015: World Journal of Gastrointestinal Endoscopy
Björn Törnqvist, Anne Waage, Zongli Zheng, Weimin Ye, Magnus Nilsson
BACKGROUND: Acute cholecystitis is a common complication to gallstone disease. The relation between the severity of acute cholecystitis and risk of bile duct injury during cholecystectomy has not yet been addressed and is the main focus of this study. METHODS: All cases with iatrogenic bile duct injury during cholecystectomy, within the Lake Mälaren region, Sweden, were identified through ICD procedure codes for biliary reconstruction within the Swedish Inpatient Register and matched to non-injured cholecystectomized controls...
May 2016: World Journal of Surgery
Thorsten Oliver Goetze
The outcome of gallbladder carcinoma is poor, and the overall 5-year survival rate is less than 5%. In early-stage disease, a 5-year survival rate up to 75% can be achieved if stage-adjusted therapy is performed. There is wide geographic variability in the frequency of gallbladder carcinoma, which can only be explained by an interaction between genetic factors and their alteration. Gallstones and chronic cholecystitis are important risk factors in the formation of gallbladder malignancies. Factors such as chronic bacterial infection, primary sclerosing cholangitis, an anomalous junction of the pancreaticobiliary duct, and several types of gallbladder polyps are associated with a higher risk of gallbladder cancer...
November 21, 2015: World Journal of Gastroenterology: WJG
Till Bornscheuer, Stefan Schmiedel
BACKGROUND: The aim of this article is to present the most recent suggestions for the therapy of acute cholangitis and cholecystitis based on a review of the current literature. METHODS: We performed a systematic literature search in the Medline, PubMed, and Google Scholar databases using the keywords mentioned above. This article is strongly influenced by the publication of the Tokyo Guidelines for the management of acute cholangitis and cholecystitis (TG07, TG13) in 2007 and 2013...
October 2014: Viszeralmedizin
Peter C Ambe, Hildegard Christ, Dirk Wassenberg
BACKGROUND: The Tokyo guidelines provide criteria for the diagnosis and classification of acute cholecystitis in three severity grades. However, no data exists on the predictive value of these guidelines. The aim of this study was to analyze the accuracy of the Tokyo guidelines as a predicting parameter for the severity of acute cholecystitis in patients undergoing laparoscopic cholecystectomy. METHODS: A retrospective analysis of the charts of patients undergoing laparoscopic cholecystectomy for acute cholecystitis in a primary care hospital within a five-year period was performed...
2015: BMC Gastroenterology
Heidi L Frankel, Andrew W Kirkpatrick, Mahmoud Elbarbary, Michael Blaivas, Himanshu Desai, David Evans, Douglas T Summerfield, Anthony Slonim, Raoul Breitkreutz, Susanna Price, Paul E Marik, Daniel Talmor, Alexander Levitov
OBJECTIVE: To establish evidence-based guidelines for the use of bedside ultrasound by intensivists and specialists in the ICU and equivalent care sites for diagnostic and therapeutic purposes for organs of the chest, abdomen, pelvis, neck, and extremities. METHODS: The Grading of Recommendations, Assessment, Development and Evaluation system was used to determine the strength of recommendations as either strong or conditional/weak and to rank the "levels" of quality of evidence into high (A), moderate (B), or low (C) and thus generating six "grades" of recommendation (1A-1B-1C-2A-2B-2C)...
November 2015: Critical Care Medicine
Michele Pisano, Marco Ceresoli, Andrea Allegri, Eugenia Belotti, Federico Coccolini, Renata Colombi, Roberto Manfredi, Francesco Margarito, Cecilia Merli, Giulia Montori, Dario Piazzalunga, Luca Ansaloni
BACKGROUND: Treatment option and timing for surgery in case of acute calculous cholecystitis (ACC) is still a matter of discussion. Tokyo Guidelines (TG13) offers some rules but they don't reflect entirely the information of Evidence Based Medicine (EBM). This study aimed to draw some consideration from our practice in the application of the guidelines and put forward the clinical, economic and organizational effect of it. METHODS: The study is a single center retrospective study based on administrative database formed by gathering information from clinical registry...
September 2015: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
Qingqiang Ni, Dongbo Chen, Rui Xu, Dong Shang
To evaluate the efficacy of percutaneous transhepatic gallbladder drainage (PTGD) for high-risk elderly patients with acute cholecystitis.Retrospective analysis of 159 acute cholecystitis patients who were admitted to General Surgery Division III of the First Affiliated Hospital of Dalian Medical University between January 2005 and November 2012. A total of 123 patients underwent laparoscopic cholecystectomy (LC), and 36 received only PTGD treatment. The LC patients were divided into 3 groups based on their preoperative treatment: group A, emergency patients (33 patients); group B (26 patients), patients who were treated with PTGD prior to LC; and group C (64 patients), patients who received nonsurgical treatment prior to LC...
August 2015: Medicine (Baltimore)
Ghalia Sabbagh, Noura Berakdar
Escherichia coli is one of the most frequent causes of many common bacterial infections, including cholecystitis, bacteremia, cholangitis, urinary tract infection (UTI), traveler's diarrhea and other clinical infections such as neonatal meningitis and pneumonia. The fatty acid biosynthesis is essential for the bacterial viability and growth. There are three types of β-ketoacyl acyl carrier protein synthase (KAS) which are important for overcoming the bacterial resistance problem. β-ketoacyl acyl carrier protein synthase I (KAS I) is member of the condensing enzyme family, which is a key catalyst in bacterial fatty acid biosynthesis, and thus an attractive target for novel antibioticsis related to the elongation of unsaturated fatty acids in bacterial fatty acid synthesis and can be a good therapeutic target of designing novel antibiotics...
September 2015: Journal of Molecular Graphics & Modelling
G Paul Wright, Kellen Stilwell, Jared Johnson, Matthew T Hefty, Mathew H Chung
BACKGROUND: The 2013 Tokyo Guidelines (TG13) for acute cholecystitis have not been studied extensively in US populations. METHODS: A retrospective review of patients with acute cholecystitis within a single system from 2009 to 2013 was performed. The diagnosis and severity of acute cholecystitis were assigned by the TG13. The primary outcome measures were length of stay and conversion to open cholecystectomy. RESULTS: Four hundred and forty-five patients with acute cholecystitis were studied...
November 2015: Journal of Hepato-biliary-pancreatic Sciences
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