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Acute cholecystitis is a common surgical emergency that, if left untreated, can result in significant morbidity and even death. It is characterized by inflammation of the gallbladder, usually caused by gallstones. The timing of surgical intervention plays a crucial role in determining patient prognosis, including the risk of complications, length of hospital stay, and overall recovery. Nowadays, the gold standard for its treatment is the laparoscopic cholecystectomy. In appropriately selected cases, laparoscopic cholecystectomy can be performed on an outpatient basis, with good results in terms of efficacy and safety.
Ambulatory laparoscopic cholecystectomy is the gold standard method for managing uncomplicated cholecystopathy. In the case of an emergency cholecystectomy, could it be managed on an ambulatory basis?
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Emergency Laparoscopic Cholecystectomy | Experimental | Emergency Laparoscopic Cholecystectomy, on an ambulatory basis |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Laparoscopic Cholecystectomy | Procedure | Emergency Laparoscopic Cholecystectomy, on an ambulatory basis |
|
| Measure | Description | Time Frame |
|---|---|---|
| Postoperative satisfaction (Satiscore) | Patient satisfaction is an attitude resulting from a person's general orientation towards the total experience of health care, in this case the quality of service provided at the surgical wards, using a simplification of the Satiscore scale, where a score of 10-15 points is considered to have a high degree of satisfaction; a score of 16-25 points is considered to have a medium-moderate degree of satisfaction; and a score > 26 points is considered to indicate dissatisfaction. | From postoperative recuperation of consciousness to discharge, on the same day, and at the first postoperative outpatient consultation one week after discharge. |
| Measure | Description | Time Frame |
|---|---|---|
| Return to oral intake. | Clinical process of shifting a patient from nil-by-mouth to eating and drinking by mouth. | From the immediate postoperative period to discharge. |
| Spontaneous urination | The patient's ability to voluntarily initiate and complete the process of passing urine without assistance from a catheter or other external intervention following a surgical procedure. |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Rubén Cuevas-MartÃnez, MD, MSc | Chihuahua City General Hospital "Dr. Salvador Zubirán Anchondo" | Study Chair |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Chihuahua City General Hospital "Dr. Salvador Zubirán Anchondo" Chihuahua, Chihuahua, Mexico 31000 | Chihuahua City | Chihuahua | 31100 | Mexico |
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| ID | Term |
|---|---|
| D041881 | Cholecystitis, Acute |
| ID | Term |
|---|---|
| D002764 | Cholecystitis |
| D005705 | Gallbladder Diseases |
| D001660 | Biliary Tract Diseases |
| D004066 | Digestive System Diseases |
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| ID | Term |
|---|---|
| D017081 | Cholecystectomy, Laparoscopic |
| ID | Term |
|---|---|
| D002763 | Cholecystectomy |
| D001662 | Biliary Tract Surgical Procedures |
| D013505 | Digestive System Surgical Procedures |
| D013514 | Surgical Procedures, Operative |
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Acute cholecystitis managed as an emergency, on an ambulatory basis
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| From the immediate postoperative period to discharge. |
| Return of bowel function. | The spontaneous expulsion of gas (flatus) after surgery. | From the postoperative period to discharge. |
| Penrose drain | The quantity of drainage is typically measured by the volume (milliliters/mL) of fluid collected on the surrounding sterile dressings. | From the postoperative period to discharge, in the case it was left in place. |
| Postoperative pain. | Acute pain occurring immediately after a surgical procedure, resulting from tissue damage (surgical incision), inflammation, or neural injury, measured with the help of a numerical scale from 0 to 10. | From the postoperative period to discharge. |
| D010535 | Laparoscopy |
| D004724 | Endoscopy |
| D019060 | Minimally Invasive Surgical Procedures |