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
Study relating to materials testing Detecting damages in non-magnetic steel through magnetism
23.07.2018 | Technische Universität Kaiserslautern
Innovative genetic tests for children with developmental disorders and epilepsy
11.07.2018 | Christian-Albrechts-Universität zu Kiel
There are currently great hopes for solid-state batteries. They contain no liquid parts that could leak or catch fire. For this reason, they do not require cooling and are considered to be much safer, more reliable, and longer lasting than traditional lithium-ion batteries. Jülich scientists have now introduced a new concept that allows currents up to ten times greater during charging and discharging than previously described in the literature. The improvement was achieved by a “clever” choice of materials with a focus on consistently good compatibility. All components were made from phosphate compounds, which are well matched both chemically and mechanically.
The low current is considered one of the biggest hurdles in the development of solid-state batteries. It is the reason why the batteries take a relatively long...
New design tool automatically creates nanostructure 3D-print templates for user-given colors
Scientists present work at prestigious SIGGRAPH conference
Most of the objects we see are colored by pigments, but using pigments has disadvantages: such colors can fade, industrial pigments are often toxic, and...
Scientists at the University of California, Los Angeles present new research on a curious cosmic phenomenon known as "whistlers" -- very low frequency packets...
Scientists develop first tool to use machine learning methods to compute flow around interactively designable 3D objects. Tool will be presented at this year’s prestigious SIGGRAPH conference.
When engineers or designers want to test the aerodynamic properties of the newly designed shape of a car, airplane, or other object, they would normally model...
Researchers from TU Graz and their industry partners have unveiled a world first: the prototype of a robot-controlled, high-speed combined charging system (CCS) for electric vehicles that enables series charging of cars in various parking positions.
Global demand for electric vehicles is forecast to rise sharply: by 2025, the number of new vehicle registrations is expected to reach 25 million per year....
17.08.2018 | Event News
08.08.2018 | Event News
27.07.2018 | Event News
20.08.2018 | Information Technology
20.08.2018 | Life Sciences
20.08.2018 | Information Technology