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:
Dr. Annette Tuffs | idw
The Great Unknown: Risk-Taking Behavior in Adolescents
19.01.2017 | Max-Planck-Institut für Bildungsforschung
A sudden drop in outdoor temperature increases the risk of respiratory infections
11.01.2017 | University of Gothenburg
An important step towards a completely new experimental access to quantum physics has been made at University of Konstanz. The team of scientists headed by...
Yersiniae cause severe intestinal infections. Studies using Yersinia pseudotuberculosis as a model organism aim to elucidate the infection mechanisms of these...
Researchers from the University of Hamburg in Germany, in collaboration with colleagues from the University of Aarhus in Denmark, have synthesized a new superconducting material by growing a few layers of an antiferromagnetic transition-metal chalcogenide on a bismuth-based topological insulator, both being non-superconducting materials.
While superconductivity and magnetism are generally believed to be mutually exclusive, surprisingly, in this new material, superconducting correlations...
Laser-driving of semimetals allows creating novel quasiparticle states within condensed matter systems and switching between different states on ultrafast time scales
Studying properties of fundamental particles in condensed matter systems is a promising approach to quantum field theory. Quasiparticles offer the opportunity...
Among the general public, solar thermal energy is currently associated with dark blue, rectangular collectors on building roofs. Technologies are needed for aesthetically high quality architecture which offer the architect more room for manoeuvre when it comes to low- and plus-energy buildings. With the “ArKol” project, researchers at Fraunhofer ISE together with partners are currently developing two façade collectors for solar thermal energy generation, which permit a high degree of design flexibility: a strip collector for opaque façade sections and a solar thermal blind for transparent sections. The current state of the two developments will be presented at the BAU 2017 trade fair.
As part of the “ArKol – development of architecturally highly integrated façade collectors with heat pipes” project, Fraunhofer ISE together with its partners...
19.01.2017 | Event News
10.01.2017 | Event News
09.01.2017 | Event News
20.01.2017 | Awards Funding
20.01.2017 | Materials Sciences
20.01.2017 | Life Sciences