Scoring System in Acute Calculous Cholecystitis

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Brief Title

Scoring System in Acute Calculous Cholecystitis

Official Title

Does the First Visit Scoring System Affect the Treatment Method in Acute Calculous Cholecystitis?

Brief Summary

      Acute cholecystitis is a common disease in the daily practice of general surgery. There are
      various methods in the treatment of this disease, such as early cholecystectomy, medical
      treatment, six weeks later cholecystectomy and cholecystostomy. However, it is not satisfied
      with objective criteria that these methods are selected according to which patient groups.
      With this observational-prospective study, the benefit of first visit scoring on 'which of
      the treatment options will be most suitable for the patient' will be investigated. Thus, rare
      but severe complications of cholecystectomy can be prevented.
    

Detailed Description

      Acute cholecystitis refers to acute inflammation of the gallbladder, and why it is often
      gallstones. Gallstones are seen in western society with about 10% frequency, while 80% of
      them are asymptomatic. Acute cholecystitis accounts for 1-3% of those with symptomatic
      gallstones.

      Acute cholecystitis is a table characterized by right upper quadrant pain (in the
      inflammatory pain pattern and continuous), defensiveness in the right upper quadrant (murphy
      manifestation is positive or not), and an increase in inflammatory response parameters (such
      as fever, white blood cell, and CRP elevation). Biliary scintigraphy, called the HIDA scan,
      is the gold standard method in diagnosis. However, due to the difficulty and cost of
      application, ultrasonography is used in the routine application in diagnosis. It is valuable
      that gallstones and gallbladder walls are thicker than 4 mm in ultrasonography. However,
      pericholecystic fluid is a more valuable finding and is rare.

      In the treatment of acute cholecystitis, the patient's hospitalization, limiting oral food
      intake, IV hydration, NSAID, and antibiotic treatment is the main conservative approaches.
      While these patients were admitted to the hospital in the first 72 hours from the onset of
      symptoms, early cholecystectomy is recommended. If they arrive later, interval
      cholecystectomy is recommended after 6-8 weeks. Laparoscopic cholecystectomy is recommended
      for all operations. However, the choice of surgical treatment is determined by the surgeon,
      according to the patient. More precise and objective criteria are needed to contribute to
      this choice.

      In a study comparing early cholecystectomy and delayed cholecystectomy, intraoperative and
      postoperative complications were more common in early cholecystectomy than interval
      cholecystectomy. Still, early cholecystectomy had better results in terms of cost and
      hospital stay. There are many studies in the literature comparing early and late
      cholecystectomy. In these studies, the selection criteria of patients are different in all of
      them.

      Finally, it was emphasized that a retrospective scoring study conducted in Germany could be
      successful in patient selection.

      In conclusion, the debate on treatment choices of patients with acute cholecystitis
      continues. Recent publications in the literature on the development of scoring systems for
      these patients draw attention, so investigators want to investigate the effectiveness of a
      scoring system in which patients are evaluated in many ways.
    


Study Type

Observational


Primary Outcome

cut off value


Condition

Acute Cholecystitis



Publications

* Includes publications given by the data provider as well as publications identified by National Clinical Trials Identifier (NCT ID) in Medline.

Recruitment Information



Estimated Enrollment

1

Start Date

March 7, 2020

Completion Date

June 15, 2020

Primary Completion Date

May 31, 2020

Eligibility Criteria

        Inclusion Criteria:

          -  Clinically and Radiologically diagnosed with acute cholecystitis

          -  be over 18 years old

        Exclusion Criteria:

          -  Being under the age of 18

          -  getting pregnant

          -  Acute pancreatitis, cholangitis or choledochal stone with acute cholecystitis

          -  Having a previous history of upper abdominal surgery
      

Gender

All

Ages

18 Years - N/A

Accepts Healthy Volunteers

No

Contacts

, , 

Location Countries

Turkey

Location Countries

Turkey

Administrative Informations


NCT ID

NCT04308265

Organization ID

Department of general surgery


Responsible Party

Principal Investigator

Study Sponsor

Konya Training and Research Hospital


Study Sponsor

, , 


Verification Date

March 2020