International Journal of Medical Science and Pharmaceutical Research

Acute calculus cholecystitis is a common surgical emergency that has traditionally been treated with conservative treatment followed by delayed laparoscopic cholecystectomy.  The Tokyo Guidelines of 2013/2018 and the World Society of Emergency Surgeons (WSES) 2020 guidelines on acute calculus cholecystitis have recommended early laparoscopic cholecystectomy. Early laparoscopic cholecystectomy is performed within 7 days from the onset of symptoms and is associated with better outcomes, shorter stay in the hospital, and reduced cost. In this review, we will investigate the role of early laparoscopic cholecystectomy and the risk of conversion to open cholecystectomy in the management of acute calculus cholecystitis.

Acute calculus cholecystitis, Cholelithiasis, Cholecystectomy, Complications, Conversion, Early laparoscopic cholecystectomy, and Tokyo Guidelines.

1. Acar, T., Kamer, E., Acar, N., Atahan, K., Bağ, H., Hacıyanlı, M., & Akgül, Ö. (2017). Laparoscopic cholecystectomy in the treatment of acute cholecystitis: comparison of results between early and late cholecystectomy. The Pan African Medical Journal, 26, 49. https://doi.org/10.11604/pamj.2017.26.49.8359
2. Agrawal, R., Sood, K. C., & Agarwal, B. (2015). Evaluation of Early versus Delayed Laparoscopic Cholecystectomy in Acute Cholecystitis. Surgery Research and Practice, 2015, 1–7. https://doi.org/10.1155/2015/349801
3. Ansaloni, L., Pisano, M., Coccolini, F., Peitzmann, A. B., Fingerhut, A., Catena, F., Agresta, F., Allegri, A., Bailey, I., Balogh, Z. J., Bendinelli, C., Biffl, W., Bonavina, L., Borzellino, G., Brunetti, F., Burlew, C. C., Camapanelli, G., Campanile, F. C., Ceresoli, M., … Moore, E. E. (2016). 2016 WSES guidelines on acute calculous cholecystitis. In World Journal of Emergency Surgery (Vol. 11, Issue 1). BioMed Central Ltd. https://doi.org/10.1186/s13017-016-0082-5
4. Bagla, P., Sarria, J. C., & Riall, T. S. (2016). Management of acute cholecystitis. In Current Opinion in Infectious Diseases (Vol. 29, Issue 5, pp. 508–513). Lippincott Williams and Wilkins. https://doi.org/10.1097/QCO.0000000000000297
5. Blohm, M., Österberg, J., Sandblom, G., Lundell, L., Hedberg, M., & Enochsson, L. (2017). The Sooner, the Better? The Importance of Optimal Timing of Cholecystectomy in Acute Cholecystitis: Data from the National Swedish Registry for Gallstone Surgery, GallRiks. Journal of Gastrointestinal Surgery, 21(1), 33–40. https://doi.org/10.1007/s11605-016-3223-y
6. Borzellino, G., Khuri, S., Pisano, M., Mansour, S., Allievi, N., Ansaloni, L., & Kluger, Y. (2021). Timing of early laparoscopic cholecystectomy for acute calculous cholecystitis: a meta-analysis of randomized clinical trials. World Journal of Emergency Surgery, 16(1). https://doi.org/10.1186/s13017-021-00360-5
7. Cao, A. M., Eslick, G. D., & Cox, M. R. (2016). Early laparoscopic cholecystectomy is superior to delayed acute cholecystitis: a meta-analysis of case–control studies. Surgical Endoscopy, 30(3), 1172–1182. https://doi.org/10.1007/s00464-015-4325-4
8. Chin, X., Mallika Arachchige, S., Orbell-Smith, J., & Wysocki, A. P. (2023). Preoperative and Intraoperative Risk Factors for Conversion of Laparoscopic Cholecystectomy to Open Cholecystectomy: A Systematic Review of 30 Studies. Cureus, 15(10), e47774. https://doi.org/10.7759/cureus.47774
9. Chung, A. Y. A., & Duke, M. C. (2018). Acute Biliary Disease. In Surgical Clinics of North America (Vol. 98, Issue 5, pp. 877–894). W.B. Saunders. https://doi.org/10.1016/j.suc.2018.05.003
10. Costanzo, M. L., D’Andrea, V., Lauro, A., & Bellini, M. I. (2023). Acute Cholecystitis from Biliary Lithiasis: Diagnosis, Management and Treatment. In Antibiotics (Vol. 12, Issue 3). MDPI. https://doi.org/10.3390/antibiotics12030482
11. Elwood, D. R. (2008). Cholecystitis. In Surgical Clinics of North America (Vol. 88, Issue 6, pp. 1241–1252). https://doi.org/10.1016/j.suc.2008.07.008
12. Fugazzola, P., Abu-Zidan, F. M., Cobianchi, L., Dal Mas, F., Ceresoli, M., Coccolini, F., Frassini, S., Tomasoni, M., Catena, F., & Ansaloni, L. (2023). Timing of Early Cholecystectomy for Acute Calculous Cholecystitis: A Multicentric Prospective Observational Study. Healthcare (Switzerland), 11(20). https://doi.org/10.3390/healthcare11202752
13. Gomes, C. A., Junior, C. S., Di Saveiro, S., Sartelli, M., Kelly, M. D., Gomes, C. C., Gomes, F. C., Correa, L. D., Alves, C. B., & Guimarães, S. de F. (2017). Acute calculous cholecystitis: Review of current best practices. World Journal of Gastrointestinal Surgery, 9(5), 118. https://doi.org/10.4240/wjgs.v9.i5.118
14. Gurusamy, K., Samraj, K., Gluud, C., Wilson, E., & Davidson, B. R. (2010). Meta-analysis of randomized controlled trials on the safety and effectiveness of early versus delayed laparoscopic cholecystectomy for acute cholecystitis. British Journal of Surgery, 97(2), 141–150. https://doi.org/10.1002/bjs.6870
15. Hartwig, W., & Büchler, M. W. (2014). Acute cholecystitis: Early versus delayed surgery. In Advances in Surgery (Vol. 48, Issue 1, pp. 155–164). Academic Press Inc. https://doi.org/10.1016/j.yasu.2014.05.008
16. Ibrahim, M., Sarvepalli, S., Morris-Stiff, G., Rizk, M., Bhatt, A., Matthew Walsh, R., Hayat, U., Garber, A., Vargo, J., & Burke, C. A. (2018). Gallstones: Watch and wait, or intervene? In Cleveland Clinic Journal of Medicine (Vol. 85, Issue 4, pp. 323–331). Cleveland Clinic Educational Foundation. https://doi.org/10.3949/ccjm.85a.17035
17. Kao, L. S., Ball, C. G., & Chaudhury, P. K. (2018). Evidence-based reviews in surgery: Early cholecystectomy for cholecystitis. Annals of Surgery, 268(6), 940–942. https://doi.org/10.1097/SLA.0000000000002867
18. Knab, L. M., Boller, A. M., & Mahvi, D. M. (2014). Cholecystitis. In Surgical Clinics of North America (Vol. 94, Issue 2, pp. 455–470). W.B. Saunders. https://doi.org/10.1016/j.suc.2014.01.005
19. Koti, R. S., Davidson, C. J., & Davidson, B. R. (2015). Surgical management of acute cholecystitis. Langenbeck’s Archives of Surgery, 400(4), 403–419. https://doi.org/10.1007/s00423-015-1306-y
20. Kuhlenschmidt, K. M., Taveras, L. R., & Cripps, M. W. (2021). Current Management of Acute Calculous Cholecystitis. In Current Surgery Reports (Vol. 9, Issue 2). Springer. https://doi.org/10.1007/s40137-020-00282-2
21. Lammert, F., Gurusamy, K., Ko, C. W., Miquel, J. F., Méndez-Sánchez, N., Portincasa, P., Van Erpecum, K. J., Van Laarhoven, C. J., & Wang, D. Q. H. (2016). Gallstones. Nature Reviews Disease Primers, 2. https://doi.org/10.1038/nrdp.2016.24
22. Loozen, C. S., Van Ramshorst, B., Van Santvoort, H. C., & Boerma, D. (2017). Early Cholecystectomy for Acute Cholecystitis in the Elderly Population: A Systematic Review and Meta-Analysis. In Digestive Surgery (Vol. 34, Issue 5, pp. 371–379). S. Karger AG. https://doi.org/10.1159/000455241
23. Lyu, Y., Cheng, Y., Wang, B., Zhao, S., & Chen, L. (2018). Early versus delayed laparoscopic cholecystectomy for acute cholecystitis: an up-to-date meta-analysis of randomized controlled trials. In Surgical Endoscopy (Vol. 32, Issue 12, pp. 4728–4741). Springer New York LLC. https://doi.org/10.1007/s00464-018-6400-0
24. Magnano San Lio, R., Barchitta, M., Maugeri, A., Quartarone, S., Basile, G., & Agodi, A. (2023). Preoperative Risk Factors for Conversion from Laparoscopic to Open Cholecystectomy: A Systematic Review and Meta-Analysis. In International Journal of Environmental Research and Public Health (Vol. 20, Issue 1). MDPI. https://doi.org/10.3390/ijerph20010408
25. Mayumi, T., Okamoto, K., Takada, T., Strasberg, S. M., Solomkin, J. S., Schlossberg, D., Pitt, H. A., Yoshida, M., Gomi, H., Miura, F., Garden, O. J., Kiriyama, S., Yokoe, M., Endo, I., Asbun, H. J., Iwashita, Y., Hibi, T., Umezawa, A., Suzuki, K., … Yamamoto, M. (2018). Tokyo Guidelines 2018: management bundles for acute cholangitis and cholecystitis. Journal of Hepato-Biliary-Pancreatic Sciences, 25(1), 96–100. https://doi.org/10.1002/jhbp.519
26. Okamoto, K., Suzuki, K., Takada, T., Strasberg, S. M., Asbun, H. J., Endo, I., Iwashita, Y., Hibi, T., Pitt, H. A., Umezawa, A., Asai, K., Han, H. S., Hwang, T. L., Mori, Y., Yoon, Y. S., Huang, W. S. W., Belli, G., Dervenis, C., Yokoe, M., … Yamamoto, M. (2018). Tokyo Guidelines 2018: flowchart for the management of acute cholecystitis. Journal of Hepato-Biliary-Pancreatic Sciences, 25(1), 55–72. https://doi.org/10.1002/jhbp.516
27. Papi, C., Catarci, M., D’Ambrosio, L., Gili, L., Koch, M., Grassi, G. B., & Capurso, L. (2004). Timing of cholecystectomy for acute calculous cholecystitis: A meta-analysis. American Journal of Gastroenterology, 99(1), 147–155. https://doi.org/10.1046/j.1572-0241.2003.04002.x
28. Pisano, M., Allievi, N., Gurusamy, K., Borzellino, G., Cimbanassi, S., Boerna, D., Coccolini, F., Tufo, A., Di Martino, M., Leung, J., Sartelli, M., Ceresoli, M., Maier, R. V., Poiasina, E., De Angelis, N., Magnone, S., Fugazzola, P., Paolillo, C., Coimbra, R., … Ansaloni, L. (2020). 2020 World Society of Emergency Surgery updated guidelines for the diagnosis and treatment of acute calculus cholecystitis. In World Journal of Emergency Surgery (Vol. 15, Issue 1). BioMed Central Ltd. https://doi.org/10.1186/s13017-020-00336-x
29. Polo, M., Duclos, A., Polazzi, S., Payet, C., Lifante, J. C., Cotte, E., Barth, X., Glehen, O., & Passot, G. (2015). Acute Cholecystitis—Optimal Timing for Early Cholecystectomy: a French Nationwide Study. Journal of Gastrointestinal Surgery, 19(11), 2003–2010. https://doi.org/10.1007/s11605-015-2909-x
30. Rosen, M., Brody, F., & Ponsky, J. (2002). Predictive factors for conversion of laparoscopic cholecystectomy. American journal of surgery, 184(3), 254–258. https://doi.org/10.1016/s0002-9610(02)00934-0
31. Schuld, J., & Glanemann, M. (2015). Acute Cholecystitis. In Viszeralmedizin: Gastrointestinal Medicine and Surgery (Vol. 31, Issue 3, pp. 163–165). S. Karger AG. https://doi.org/10.1159/000431275
32. Shikata, S., Noguchi, Y., & Fukui, T. (2005). Early versus delayed cholecystectomy for acute cholecystitis: A meta-analysis of randomized controlled trials. Surgery Today, 35(7), 553–560. https://doi.org/10.1007/s00595-005-2998-3
33. Sippey, M., Grzybowski, M., Manwaring, M. L., Kasten, K. R., Chapman, W. H., Pofahl, W. E., Pories, W. J., & Spaniolas, K. (2015). Acute cholecystitis: Risk factors for conversion to an open procedure. Journal of Surgical Research, 199(2), 357–361. https://doi.org/10.1016/j.jss.2015.05.040
34. Strasberg S. M. (2008). Clinical practice. Acute calculous cholecystitis. The New England journal of medicine, 358(26), 2804–2811. https://doi.org/10.1056/NEJMcp0800929
35. Takada, T., Strasberg, S. M., Solomkin, J. S., Pitt, H. A., Gomi, H., Yoshida, M., Mayumi, T., Miura, F., Gouma, D. J., Garden, O. J., Büchler, M. W., Kiriyama, S., Yokoe, M., Kimura, Y., Tsuyuguchi, T., Itoi, T., Gabata, T., Higuchi, R., Okamoto, K., … Sumiyama, Y. (2013). TG13: Updated Tokyo Guidelines for the management of acute cholangitis and cholecystitis. Journal of Hepato-Biliary-Pancreatic Sciences, 20(1), 1–7. https://doi.org/10.1007/s00534-012-0566-y
36. Terho, P. M., Leppäniemi, A. K., & Mentula, P. J. (2016). Laparoscopic cholecystectomy for acute calculous cholecystitis: A retrospective study assessing risk factors for conversion and complications. World Journal of Emergency Surgery, 11(1). https://doi.org/10.1186/s13017-016-0111-4
37. Thangavelu, A., Rosenbaum, S., & Thangavelu, D. (2018). Timing of Cholecystectomy in Acute Cholecystitis. In Journal of Emergency Medicine (Vol. 54, Issue 6, pp. 892–897). Elsevier USA. https://doi.org/10.1016/j.jemermed.2018.02.045
38. van der Steeg, H.J., Alexander, S., Houterman, S., Slooter, G.D., & Roumen, R.M. (2011). Risk Factors for Conversion during Laparoscopic Cholecystectomy — Experiences from a General Teaching Hospital. Scandinavian Journal of Surgery, 100, 169 - 173.
39. Wiggins, T., Markar, S. R., MacKenzie, H., Faiz, O., Mukherjee, D., Khoo, D. E., Purkayastha, S., Beckingham, I., & Hanna, G. B. (2019). Optimum timing of emergency cholecystectomy for acute cholecystitis in England: population-based cohort study. Surgical Endoscopy, 33(8), 2495–2502. https://doi.org/10.1007/s00464-018-6537-x
40. Wu, X. D., Tian, X., Liu, M. M., Wu, L., Zhao, S., & Zhao, L. (2015). Meta-analysis comparing early versus delayed laparoscopic cholecystectomy for acute cholecystitis. In British Journal of Surgery (Vol. 102, Issue 11, pp. 1302–1313). John Wiley and Sons Ltd. https://doi.org/10.1002/bjs.9886
41. Yamashita, Y., Takada, T., Strasberg, S. M., Pitt, H. A., Gouma, D. J., Garden, O. J., Büchler, M. W., Gomi, H., Dervenis, C., Windsor, J. A., Kim, S. W., De Santibanes, E., Padbury, R., Chen, X. P., Chan, A. C. W., Fan, S. T., Jagannath, P., Mayumi, T., Yoshida, M., … Supe, A. N. (2013). TG13 surgical management of acute cholecystitis. Journal of Hepato-Biliary-Pancreatic Sciences, 20(1), 89–96. https://doi.org/10.1007/s00534-012-0567-x