Surgical management of acute cholecystitis. Results of a nation-wide survey among Spanish surgeons

Abstract

There is a wide variability in the management of acute cholecystitis. A survey among the members of the Spanish Association of Surgeons (AEC) analyzed the preferences of Spanish surgeons for its surgical management. The majority of the 771 responders didn't declare any subspecialty (41.6%), 21% were HPB surgeons, followed by colorectal and upper-GI specialities. Early cholecystectomy during the first admission is the preferred method of management of 92.3% of surgeons, but only 42.7% succeed in adopting this practice. The most frequent reasons for changing their preferred practice were: Patients not fit for surgery (43.6%) and lack of availability of emergency operating room (35.2%). A total of 88.9% perform surgery laparoscopically. The majority of AEC surgeons advise index admission cholecystectomy for acute cholecystitis, although only half of them succeed in its actual implementation. There is room for improvement in the management of acute cholecystitis in Spanish hospitals.

Keywords: Acute cholecystitis; Cirugía diferida; Cirugía precoz; Colecistectomía laparoscópica; Colecistitis aguda; Delayed cholecystectomy; Early cholecystectomy; Encuesta; Laparoscopic cholecystectomy; Management; Manejo; Survey.