Brief Title
Scoring System in Acute Calculous Cholecystitis
Official Title
Does the Scoring System Affect the Surgery Timing 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
March 15, 2021
Primary Completion Date
February 28, 2021
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 Meram State Hospital
Study Sponsor
, ,
Verification Date
March 2021