Please use this identifier to cite or link to this item:
Type: Artigo
Title: 2020 World society of emergency surgery updated guidelines for the diagnosis and treatment of acute calculus cholecystitis
Author: Pisano, Michele
Allievi, Niccolo
Gurusamy, Kurinchi
Borzellino, Giuseppe
Cimbanassi, Stefania
Boerna, Djamila
Coccolini, Federico
Tufo, Andrea
Di Martino, Marcello
Leung, Jeffrey
Sartelli, Massimo
Ceresoli, Marco
Maier, Ronald, V
Poiasina, Elia
De Angelis, Nicola
Magnone, Stefano
Fugazzola, Paola
Paolillo, Ciro
Coimbra, Raul
Di Saverio, Salomone
De Simone, Belinda
Weber, Dieter G.
Sakakushev, Boris E.
Lucianetti, Alessandro
Kirkpatrick, Andrew W.
Fraga, Gustavo P.
Wani, Imitaz
Biffl, Walter L.
Chiara, Osvaldo
Abu-Zidan, Fikri
Moore, Ernest E.
Leppaniemi, Ari
Kluger, Yoram
Catena, Fausto
Ansaloni, Luca
Abstract: Acute calculus cholecystitis (ACC) has a high incidence in the general population. The presence of several areas of uncertainty, along with the availability of new evidence, prompted the current update of the 2016 WSES (World Society of Emergency Surgery) Guidelines on ACC.The WSES president appointed four members as a scientific secretariat, four members as an organization committee and four members as a scientific committee, choosing them from the expert affiliates of WSES. Relevant key questions were constructed, and the task force produced drafts of each section based on the best scientific evidence from PubMed and EMBASE Library; recommendations were developed in order to answer these key questions. The quality of evidence and strength of recommendations were reviewed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) criteria (see All the statements were presented, discussed and voted upon during the Consensus Conference at the 6th World Congress of the World Society of Emergency Surgery held in Nijmegen (NL) in May 2019. A revised version of the statements was voted upon via an online questionnaire until consensus was reached. The pivotal role of surgery is confirmed, including in high-risk patients. When compared with the WSES 2016 guidelines, the role of gallbladder drainage is reduced, despite the considerable technical improvements available. Early laparoscopic cholecystectomy (ELC) should be the standard of care whenever possible, even in subgroups of patients who are considered fragile, such as the elderly; those with cardiac disease, renal disease and cirrhosis; or those who are generally at high risk for surgery. Subtotal cholecystectomy is safe and represents a valuable option in cases of difficult gallbladder removal.ELC has a central role in the management of patients with ACC. The value of surgical treatment for high-risk patients should lead to a distinction between high-risk patients and patients who are not suitable for surgery. Further evidence on the role of clinical judgement and the use of clinical scores as adjunctive tools to guide treatment of high-risk patients and patients who are not suitable for surgery is required. The development of local policies for safe laparoscopic cholecystectomy is recommended
Subject: Colecistectomia
Country: Reino Unido
Editor: Springer Nature
Rights: Aberto
Identifier DOI: 0.1186/s13017-020-00336-x
Date Issue: 2020
Appears in Collections:FCM - Artigos e Outros Documentos

Files in This Item:
File Description SizeFormat 
000586869100001.pdf1.37 MBAdobe PDFView/Open

Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.