Abstract
Background: Acute cholecystitis represents a common cause of acute abdominal pain in patients presenting to the emergency department, representing a significant public health problem encountered by surgeons and physicians. Cholecystectomy has emerged as the definitive treatment of acute cholecystitis, whether immediate, early, or delayed.
The objective of this study is to evaluate the severity of acute cholecystitis and its outcome in patients attending Baghdad Teaching Hospital.
Patients and Methods
A cross-sectional study was conducted in the surgical wards of Baghdad Teaching Hospital between 1 May 2015 and the end of January 2016. A total of 115 patients diagnosed with acute cholecystitis were included in this study. The severity of the attack was assessed, and management plans were devised in accordance with the Tokyo guidelines.
The mean age of patients was 51 years, with the 41-50 age group representing the most frequent age group affected (35.6%).
In this study, 59.1% of cases were classified as grade 1 severity, 37.3% as grade 2, and 3.4% as grade 3.
In regard to grade 1 (mild), no patients underwent immediate surgery. Twenty-seven-point-nine percent had early surgery, and eighty-eight-point-three percent had delayed surgery.
With regard to the type of surgery, 83.8% of patients with grade 1 severity underwent laparoscopic cholecystectomy, while 16% underwent open surgery. In grade 2, 76.7% underwent laparoscopic surgery, and 23.2% underwent open surgery. In contrast, all patients with grade 3 severity underwent an open cholecystectomy.
Conclusions
The majority of cases were classified as mild in severity. Male gender was identified as a significant risk factor for severe acute attacks. The optimal timing for laparoscopic cholecystectomy was determined to be within the first 72 hours of the attack. For mild cases, early laparoscopic cholecystectomy was identified as the preferred procedure. For severe cases, gallbladder drainage was the most common procedure