2017 WSES and SICG guidelines on acute calcolous cholecystitis in elderly population

World Journal of Emergency Surgery

Elia Poiasina¹  Luca Campanati¹  Stefano Magnone¹  Niccolò Allievi¹  Michele Pisano¹  Pietro Calcagno¹  Salomone di Saverio²  Bruno Amato³  Fausto Catena⁴  Yoram Kluger⁵  Djamila Boerma⁶  Giuseppe Borzellino⁷  Luca Ansaloni⁷  Kurinchi Gurusamy⁸  Marco Filauro⁹  Angelo Guttadauro^1,10  Francesco Gabrielli^1,10  Marco Ceresoli^1,10  Alessandro Puzziello^1,11  Antonio Crucitti^1,12  Federico Coccolini^1,13  Osvaldo Chiara^1,14  Stefania Cimbanassi^1,14  Fabio Cesare Campanile^1,15  Massimo Sartelli^1,16  Gianluca Costa^1,17  Alberto Casati^1,18  Cecilia Merli^1,19 

[1] 1st Surgical Unit, Department of Emergency, Papa Giovanni Hospital XXIII;Cambridge Colorectal Unit, Box 201,Cambridge University Hospitals NHS Foundation Trust, Addenbrooke’s Hospital;Department of Clinical Medicine and Surgery, University of Naples Federico II, Medical School;Department of Emergency Surgery, Parma Maggiore Hospital;Department of General Surgery, Division of Surgery;Department of Surgery, St. Antonius Hospital;Department of Surgery, University Hospital of Verona;Division of Surgery and Interventional Science, University College London;E.O.Ospedale Galliera di Genova, SC Chirurgia generale ed epatobiliopancreatica;General Surgery Department, Milano-Bicocca University, School of Medicine and Surgery;General and Day Surgery Unit, San Giovanni di Dio Hospital, University of Salerno;General and Minimally Invasive Surgery Unit, Cristo Re Hospital, Sacro Cuore Catholic University;General, Emergency and Trauma Surgery, Bufalini Hospital;Milano Trauma Network, ASST Niguarda Hospital;Ospedale San Giovanni Decollato;Surgical Department, Hospital of Macerata;Surgical and Medical Department of Translational Medicine, Sant’Andrea Teaching Hospital, “Sapienza” University of Rome;Trauma Surgery, Maggiore Hospital;Unit of Emergency Medicine Bufalini Hospital;

关键词: Acute calcolous cholecystitis;    Elderly;    Frailty;    High-risk patients;    Diagnosis;    Surgery;   

DOI  :  10.1186/s13017-019-0224-7

来源: DOAJ

【 摘 要 】

Abstract Background Gallstone disease is very common afflicting 20 million people in the USA. In Europe, the overall incidence of gallstone disease is 18.8% in women and 9.5% in men. The frequency of gallstones related disease increases by age. The elderly population is increasing worldwide. Aim The present guidelines aims to report the results of the World Society of Emergency Surgery (WSES) and Italian Surgical Society for Elderly (SICG) consensus conference on acute calcolous cholecystitis (ACC) focused on elderly population. Material and methods The 2016 WSES guidelines on ACC were used as baseline; six questions have been used to investigate the particularities in elderly population; the answers have been developed in terms of differences compared to the general population and to statements of the 2016 WSES Guidelines. The Consensus Conference discusses, voted, and modified the statements. International experts contributed in the elaboration of final statements and evaluation of the level of scientific evidences. Results The quality of the studies available decreases when we approach ACC in elderly. Same admission laparoscopic cholecystectomy should be suggested for elderly people with ACC; frailty scores as well as clinical and surgical risk scores could be adopted but no general consensus exist. The role of cholecystostomy is uncertain. Discussion and conclusions The evaluation of pro and cons for surgery or for alternative treatments in elderly suffering of ACC is more complex than in young people; also, the oldest old age is not a contraindication for surgery; however, a larger use of frailty and surgical risk scores could contribute to reach the best clinical judgment by the surgeon. The present guidelines offer the opportunity to share with the scientific community a baseline for future researches and discussion.

【 授权许可】

Unknown