The Real World of Acute Cholecystitis
The Real World of Acute Cholecystitis
Meta-analysis of randomized controlled trials and population based studies in acute
 cholecystitis are in favor for early laparoscopic surgery versus a delayed operation several
 weeks later. The main problems in these studies are the exclusion criteria used, thus not
 reflecting the real world setting of acute cholecystitis. The purpose of this study is to
 demonstrate that a delayed laparoscopic cholecystectomy in a real world scenario has no worse
 outcome in comparison with an early operation (within 72 hours after onset of symptoms).
Background:

 Randomized controlled trials (RCTs) and population based studies are in favor of an early
 operation in acute cholecystitis (1, 2). Thus, one of the largest RCT so far, demonstrated
 significant more complications in a group of delayed cholecystectomy. The main problems in
 these studies are the exclusion criteria used, ie severe cases are not considered.

 Objective:

 In a cohort study all cholecystectomy patients are analysed to demonstrate that delayed
 laparoscopic cholecystectomy (DLC) in a real world setting has a less complication rate than
 early cholecystectomy (ELC).

 Setting:

 Academic Teaching Hospital with 400 beds, seven departments (anesthesiology and intensive
 care medicine, orthopaedics and trauma surgery, visceral and thoracic surgery,
 gastroenterology, cardiology, gynecology and obstetrics, psychiatry. The visceral and
 thoracic department has a main focus on minimally invasive techniques.

 Participants:

 All cholecystectomy patients during 1/2006 and 9/2015

 Variables:

 Clavien Dindo Complication score, American Society of Anaesthesiologist (ASA) Score,
 conversion rate, onset of symptoms, histology, hospital stay

 Data sources:

 Chart analyses
Inclusion Criteria:

 -  All patients with cholecystectomies

 Exclusion Criteria:

 -  No exclusion criteria