Evaluating the appropriate surgical management in the cases of acute calculous cholecystitis with metabolic syndrome

There are a lot of approaches varying from clinic-to-clinic and surgeon-to-surgeon about application and timing of surgery and the role of the medication for the treatment of acute calculous cholecystitis, commonly seen in the surgery clinics. The aim of this study is, trying to assess which surgical approach has better results, in the patients with metabolic syndrome have acute cholecystitis episodes. The postoperative results of 121 patients (83 women, 38 men) who has operated as an emergency or electively between January 2012 and May 2014 at Surgery Department of Akdeniz University Hospital were retrospectively evaluated. SPSS (Version22.0) was used for statistical data analysis. The study group consisted of 83 women and 38 men with a mean age of 56,5. The postoperative results are evaluated due to timing and technical type of the surgical approach. In point of duration of surgeries, it's seen that emergency cholecystectomies took average 87.35 minutes and have an average 3,2 discharging days; whereas elective cases' results are 70.14 minutes and 4.13 days, respectively. On the other hand, when the emergency cases are categorized by the type of surgery (laparoscopic vs. open approach), it's calculated that emergency & laparoscopic cases' average duration is 83.75 minutes and emergency&open cases' duration is avg. 89.68 minutes; the mean discharging times are 4.8 and 7.1 days respectively. In comparison of the postoperative outcomes of emergency and elective cholecystectomies -independently type of surgery-, except the high rates of choledocothiasis outcomes in emergency cases, there is no significant statistical difference between two groups. Nevertheless, conformable outcomes are achieved between emergency and elective groups, when laparoscopic and open approaches were compared. When postoperative outcomes are compared according to comorbidities, apart from lower operation durations of patients with chronic obstructive lung disease, it's concluded that they have no affirmative or unfavorable effect as independent risk factor. Consequently, laparoscopic cholecystectomy that applied in the first 72-hour from admission in metabolic syndrome patients, who admitted to health institutions with acute calculous cholecystitis, -despite the higher rates of conversion to open cholecystectomy- has better or approximate postoperative outcomes in proportion to elective cases.