Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

In patients with acute cholecystitis, surgery should be performed immediately

17.09.2013
Study led by Heidelberg University Hospital’s Department of Surgery proves advantages of immediate surgery over delaying surgery until after antibiotic treatment/Publication in Annals of Surgery

Should surgery be performed immediately, or is it better to first administer antibiotics and then perform surgery? A study led by Heidelberg University Hospital Department of Surgery has demonstrated that patients suffering from acute cholecystitis should be operated on immediately.

There are no advantages to delaying surgery until antibiotic therapy has been administered for several weeks. After undergoing surgery performed within 24 hours of diagnosis, the patients have fewer complications, are back on their feet earlier, and can leave the hospital more quickly.

“With this study, we were finally able to present scientific evidence that allows us to resolve years of controversy,” explained Prof. Markus W. Büchler, Director of Heidelberg University Hospital’s Department of Surgery. The results of the ACDC study (“Acute cholecystitis – early laparoscopic surgery versus antibiotic therapy and delayed elective cholecystectomy”) have now been published in the U.S. journal Annals of Surgery.

The major risk factors for acute inflammation of the gallbladder (cholecystitis) are gallstones and increasing age. If left untreated, the gallbladder can rupture, leading to severe infections in the adjacent organs and in the abdominal cavity. Today, the gallbladder is usually removed laparoscopically without requiring a large abdominal incision. However, previously there was no consensus on the optimal timing for the procedure.

Fewer complications and complaints when surgery is performed immediately after admission

The ACDC study was jointly conducted by surgeons and internists at several centers in Germany. It is the first clinical study to prospectively investigate the two treatment approaches – early and delayed surgery – and involved two large groups composed of approximately 300 patients each who were randomly assigned to the groups.

The treatment outcomes were analyzed 75 days post-surgery. Patients undergoing early surgery reported significantly fewer complaints and complications (11.8%) compared to patients in whom an initially conservative approach (34.4%) was used. In economic terms, too, the evidence points to the advantages of early gallbladder removal: Patients undergoing surgery immediately stayed in the hospital only 5.4 days on average compared to patients for whom surgery was delayed, whose stays were 10 days on average. This translated into significantly lower hospitalization costs (€2,919/€4,262).The ACDC study’s authors concluded that “immediate laparoscopic cholecystectomy should become the therapy of choice for acute cholecystitis in operable patients.”

World-class General, Visceral and Transplantation Surgery Department

The Heidelberg General, Visceral and Transplantation Surgery has an outstanding reputation worldwide – thanks to its excellence in abdominal surgery and transplantation. Every year, around 5.000 patients are treated on an inpatient basis, with around 50.000 undergoing outpatient treatment. The interdisciplinary team performs over 8.000 visceral surgical procedures annually, 1.100 of which involve the gallbladder.

Literature: Gutt, C., Buechler MW et al: Acute Cholecystitis – Early Versus Delayed Cholecyytectomy, A Multicenter Randomised Trial, Annals of Surgery 2013; 258 (3): 385–393 / doi: 10.1097/SLA.0b013e3182a1599b)

For more information, go to the website at:
Five questions for Prof. Markus Büchler on the ACDC study in the “Ärzteblatt online” (in German): http://www.aerzteblatt.de/nachrichten/55679/Akute-Cholezystitis-Fruehzeitige-Operation-ist-dem-konservativen-Vorgehen-ueberlegen
Heidelberg University Hospital’s Department of Surgery homepage:
http://www.klinikum.uni-heidelberg.de/index.php?id=100293&L=1
Contact:
Prof. Markus W. Büchler
Managing Director
Heidelberg University Hospital – Department of Surgery
Email: Markus.Buechler@med.uni-heidelberg.de
Email to department office: Irmgard.Alffermann@med.uni-heidelberg.de
Tel: +49 (0)6221 56-6201
Heidelberg University Hospital and Medical Faculty:
Internationally recognized patient care, research, and teaching
Heidelberg University Hospital is one of the largest and most prestigious medical centers in Germany. The Medical Faculty of Heidelberg University belongs to the internationally most renowned biomedical research institutions in Europe. Both institutions have the common goal of developing new therapies and implementing them rapidly for patients. With about 11,000 employees, training and qualification is an important issue. Every year, around 118,000 patients are treated on an inpatient basis and around 1.000.000 cases on an outpatient basis in more than 50 clinics and departments with 2,200 beds. Currently, about 3,500 future physicians are studying in Heidelberg; the reform Heidelberg Curriculum Medicinale (HeiCuMed) is one of the top medical training programs in Germany.
Requests by journalists:
Dr. Annette Tuffs
Director, Corporate Communication/Public Relations
University Hospital and
Medical Faculty of Heidelberg
Im Neuenheimer Feld 672
69120 Heidelberg
Germany
phone: +49 6221 / 56 45 36
fax: +49 6221 / 56 45 44
e-mail: annette.tuffs@med.uni-heidelberg.de
Selected english press releases online:
http://www.klinikum.uni-heidelberg.de/presse
--------------------------------------------------------------------------------

Dr. Annette Tuffs | idw
Further information:
http://www.klinikum.uni-heidelberg.de

More articles from Studies and Analyses:

nachricht Win-win strategies for climate and food security
02.10.2017 | International Institute for Applied Systems Analysis (IIASA)

nachricht The personality factor: How to foster the sharing of research data
06.09.2017 | ZBW – Leibniz-Informationszentrum Wirtschaft

All articles from Studies and Analyses >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: Neutron star merger directly observed for the first time

University of Maryland researchers contribute to historic detection of gravitational waves and light created by event

On August 17, 2017, at 12:41:04 UTC, scientists made the first direct observation of a merger between two neutron stars--the dense, collapsed cores that remain...

Im Focus: Breaking: the first light from two neutron stars merging

Seven new papers describe the first-ever detection of light from a gravitational wave source. The event, caused by two neutron stars colliding and merging together, was dubbed GW170817 because it sent ripples through space-time that reached Earth on 2017 August 17. Around the world, hundreds of excited astronomers mobilized quickly and were able to observe the event using numerous telescopes, providing a wealth of new data.

Previous detections of gravitational waves have all involved the merger of two black holes, a feat that won the 2017 Nobel Prize in Physics earlier this month....

Im Focus: Smart sensors for efficient processes

Material defects in end products can quickly result in failures in many areas of industry, and have a massive impact on the safe use of their products. This is why, in the field of quality assurance, intelligent, nondestructive sensor systems play a key role. They allow testing components and parts in a rapid and cost-efficient manner without destroying the actual product or changing its surface. Experts from the Fraunhofer IZFP in Saarbrücken will be presenting two exhibits at the Blechexpo in Stuttgart from 7–10 November 2017 that allow fast, reliable, and automated characterization of materials and detection of defects (Hall 5, Booth 5306).

When quality testing uses time-consuming destructive test methods, it can result in enormous costs due to damaging or destroying the products. And given that...

Im Focus: Cold molecules on collision course

Using a new cooling technique MPQ scientists succeed at observing collisions in a dense beam of cold and slow dipolar molecules.

How do chemical reactions proceed at extremely low temperatures? The answer requires the investigation of molecular samples that are cold, dense, and slow at...

Im Focus: Shrinking the proton again!

Scientists from the Max Planck Institute of Quantum Optics, using high precision laser spectroscopy of atomic hydrogen, confirm the surprisingly small value of the proton radius determined from muonic hydrogen.

It was one of the breakthroughs of the year 2010: Laser spectroscopy of muonic hydrogen resulted in a value for the proton charge radius that was significantly...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

Event News

ASEAN Member States discuss the future role of renewable energy

17.10.2017 | Event News

World Health Summit 2017: International experts set the course for the future of Global Health

10.10.2017 | Event News

Climate Engineering Conference 2017 Opens in Berlin

10.10.2017 | Event News

 
Latest News

Los Alamos researchers and supercomputers help interpret the latest LIGO findings

18.10.2017 | Physics and Astronomy

Study shows how water could have flowed on 'cold and icy' ancient Mars

18.10.2017 | Physics and Astronomy

Navigational view of the brain thanks to powerful X-rays

18.10.2017 | Life Sciences

VideoLinks
B2B-VideoLinks
More VideoLinks >>>