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1. 2020 WSES guidelines for the detection and management of bile duct injury during cholecystectomy

Author

DeAngelis, Nicola, Catena, Fausto, Memeo, Riccardo, Coccolini, Federico, Martinez-Perez, Aleix, Romeo, Oreste M., De Simone, Belinda, Di Saverio, Salomone, Brustia, Raffaele, Rhaiem, Rami, Piardi, Tullio, Conticchio, Maria, Marchegiani, Francesco, Beghdadi, Nassiba, Abu-Zidan, Fikri M., Alikhanov, Ruslan, Allard, Marc-Antoine, Allievi, Niccolo, Amaddeo, Giuliana, Ansaloni, Luca, Andersson, Roland, Andolfi, Enrico, Azfar, Mohammad, Bala, Miklosh, Benkabbou, Amine, Ben-Ishay, Offir, Bianchi, Giorgio, Biffl, Walter L., Brunetti, Francesco, Carra, Maria Clotilde, Casanova, Daniel, Celentano, Valerio, Ceresoli, Marco, Chiara, Osvaldo, Cimbanassi, Stefania, Bini, Roberto, Coimbra, Raul, Luigi deAngelis, Gianm, Decembrino, Francesco, De Palma, Andrea, de Reuver, Philip R., Domingo, Carlos, Cotsoglou, Christian, Ferrero, Alessandro, Fraga, Gustavo P., Gaiani, Federica, Gheza, Federico, Gurrado, Angela, Harrison, Ewen, Henriquez, Angel, Hofmeyr, Stefan, Iadarola, Roberta, Kashuk, Jeffry L., Kianmanesh, Reza, Kirkpatrick, Andrew W., Kluger, Yoram, Landi, Filippo, Langella, Serena, Lapointe, Real, Le Roy, Bertrand, Luciani, Alain, Machado, Fernando, Maggi, Umberto, Maier, Ronald V., Mefire, Alain Chichom, Hiramatsu, Kazuhiro, Ordonez, Carlos, Patrizi, Franca, Planells, Manuel, Peitzman, Andrew B., Pekolj, Juan, Perdigao, Fabiano, Pereira, Bruno M., Pessaux, Patrick, Pisano, Michele, Puyana, Juan Carlos, Rizoli, Sandro, Portigliotti, Luca, Romito, Raffaele, Sakakushev, Boris, Sanei, Behnam, Scatton, Olivier, Serradilla-Martin, Mario, Schneck, Anne-Sophie, Sissoko, Mohammed Lamine, Sobhani, Iradj, ten Broek, Richard P., Testini, Mario, Valinas, Roberto, Veloudis, Giorgos, Vitali, Giulio Cesare, Weber, Dieter, Zorcolo, Luigi, Giuliante, Felice, Gavriilidis, Paschalis, Fuks, David, Sommacale, Daniele, DeAngelis, Nicola, Catena, Fausto, Memeo, Riccardo, Coccolini, Federico, Martinez-Perez, Aleix, Romeo, Oreste M., De Simone, Belinda, Di Saverio, Salomone, Brustia, Raffaele, Rhaiem, Rami, Piardi, Tullio, Conticchio, Maria, Marchegiani, Francesco, Beghdadi, Nassiba, Abu-Zidan, Fikri M., Alikhanov, Ruslan, Allard, Marc-Antoine, Allievi, Niccolo, Amaddeo, Giuliana, Ansaloni, Luca, Andersson, Roland, Andolfi, Enrico, Azfar, Mohammad, Bala, Miklosh, Benkabbou, Amine, Ben-Ishay, Offir, Bianchi, Giorgio, Biffl, Walter L., Brunetti, Francesco, Carra, Maria Clotilde, Casanova, Daniel, Celentano, Valerio, Ceresoli, Marco, Chiara, Osvaldo, Cimbanassi, Stefania, Bini, Roberto, Coimbra, Raul, Luigi deAngelis, Gianm, Decembrino, Francesco, De Palma, Andrea, de Reuver, Philip R., Domingo, Carlos, Cotsoglou, Christian, Ferrero, Alessandro, Fraga, Gustavo P., Gaiani, Federica, Gheza, Federico, Gurrado, Angela, Harrison, Ewen, Henriquez, Angel, Hofmeyr, Stefan, Iadarola, Roberta, Kashuk, Jeffry L., Kianmanesh, Reza, Kirkpatrick, Andrew W., Kluger, Yoram, Landi, Filippo, Langella, Serena, Lapointe, Real, Le Roy, Bertrand, Luciani, Alain, Machado, Fernando, Maggi, Umberto, Maier, Ronald V., Mefire, Alain Chichom, Hiramatsu, Kazuhiro, Ordonez, Carlos, Patrizi, Franca, Planells, Manuel, Peitzman, Andrew B., Pekolj, Juan, Perdigao, Fabiano, Pereira, Bruno M., Pessaux, Patrick, Pisano, Michele, Puyana, Juan Carlos, Rizoli, Sandro, Portigliotti, Luca, Romito, Raffaele, Sakakushev, Boris, Sanei, Behnam, Scatton, Olivier, Serradilla-Martin, Mario, Schneck, Anne-Sophie, Sissoko, Mohammed Lamine, Sobhani, Iradj, ten Broek, Richard P., Testini, Mario, Valinas, Roberto, Veloudis, Giorgos, Vitali, Giulio Cesare, Weber, Dieter, Zorcolo, Luigi, Giuliante, Felice, Gavriilidis, Paschalis, Fuks, David, and Sommacale, Daniele

Abstract

Bile duct injury (BDI) is a dangerous complication of cholecystectomy, with significant postoperative sequelae for the patient in terms of morbidity, mortality, and long-term quality of life. BDIs have an estimated incidence of 0.4-1.5%, but considering the number of cholecystectomies performed worldwide, mostly by laparoscopy, surgeons must be prepared to manage this surgical challenge. Most BDIs are recognized either during the procedure or in the immediate postoperative period. However, some BDIs may be discovered later during the postoperative period, and this may translate to delayed or inappropriate treatments. Providing a specific diagnosis and a precise description of the BDI will expedite the decision-making process and increase the chance of treatment success. Subsequently, the choice and timing of the appropriate reconstructive strategy have a critical role in long-term prognosis. Currently, a wide spectrum of multidisciplinary interventions with different degrees of invasiveness is indicated for BDI management. These World Society of Emergency Surgery (WSES) guidelines have been produced following an exhaustive review of the current literature and an international expert panel discussion with the aim of providing evidence-based recommendations to facilitate and standardize the detection and management of BDIs during cholecystectomy. In particular, the 2020 WSES guidelines cover the following key aspects: (1) strategies to minimize the risk of BDI during cholecystectomy; (2) BDI rates in general surgery units and review of surgical practice; (3) how to classify, stage, and report BDI once detected; (4) how to manage an intraoperatively detected BDI; (5) indications for antibiotic treatment; (6) indications for clinical, biochemical, and imaging investigations for suspected BDI; and (7) how to manage a postoperatively detected BDI.

Published
2021
Full Text
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2. 2020 WSES guidelines for the detection and management of bile duct injury during cholecystectomy

Author

DeAngelis, Nicola, Catena, Fausto, Memeo, Riccardo, Coccolini, Federico, Martinez-Perez, Aleix, Romeo, Oreste M., De Simone, Belinda, Di Saverio, Salomone, Brustia, Raffaele, Rhaiem, Rami, Piardi, Tullio, Conticchio, Maria, Marchegiani, Francesco, Beghdadi, Nassiba, Abu-Zidan, Fikri M., Alikhanov, Ruslan, Allard, Marc-Antoine, Allievi, Niccolo, Amaddeo, Giuliana, Ansaloni, Luca, Andersson, Roland, Andolfi, Enrico, Azfar, Mohammad, Bala, Miklosh, Benkabbou, Amine, Ben-Ishay, Offir, Bianchi, Giorgio, Biffl, Walter L., Brunetti, Francesco, Carra, Maria Clotilde, Casanova, Daniel, Celentano, Valerio, Ceresoli, Marco, Chiara, Osvaldo, Cimbanassi, Stefania, Bini, Roberto, Coimbra, Raul, Luigi deAngelis, Gianm, Decembrino, Francesco, De Palma, Andrea, de Reuver, Philip R., Domingo, Carlos, Cotsoglou, Christian, Ferrero, Alessandro, Fraga, Gustavo P., Gaiani, Federica, Gheza, Federico, Gurrado, Angela, Harrison, Ewen, Henriquez, Angel, Hofmeyr, Stefan, Iadarola, Roberta, Kashuk, Jeffry L., Kianmanesh, Reza, Kirkpatrick, Andrew W., Kluger, Yoram, Landi, Filippo, Langella, Serena, Lapointe, Real, Le Roy, Bertrand, Luciani, Alain, Machado, Fernando, Maggi, Umberto, Maier, Ronald V., Mefire, Alain Chichom, Hiramatsu, Kazuhiro, Ordonez, Carlos, Patrizi, Franca, Planells, Manuel, Peitzman, Andrew B., Pekolj, Juan, Perdigao, Fabiano, Pereira, Bruno M., Pessaux, Patrick, Pisano, Michele, Puyana, Juan Carlos, Rizoli, Sandro, Portigliotti, Luca, Romito, Raffaele, Sakakushev, Boris, Sanei, Behnam, Scatton, Olivier, Serradilla-Martin, Mario, Schneck, Anne-Sophie, Sissoko, Mohammed Lamine, Sobhani, Iradj, ten Broek, Richard P., Testini, Mario, Valinas, Roberto, Veloudis, Giorgos, Vitali, Giulio Cesare, Weber, Dieter, Zorcolo, Luigi, Giuliante, Felice, Gavriilidis, Paschalis, Fuks, David, Sommacale, Daniele, DeAngelis, Nicola, Catena, Fausto, Memeo, Riccardo, Coccolini, Federico, Martinez-Perez, Aleix, Romeo, Oreste M., De Simone, Belinda, Di Saverio, Salomone, Brustia, Raffaele, Rhaiem, Rami, Piardi, Tullio, Conticchio, Maria, Marchegiani, Francesco, Beghdadi, Nassiba, Abu-Zidan, Fikri M., Alikhanov, Ruslan, Allard, Marc-Antoine, Allievi, Niccolo, Amaddeo, Giuliana, Ansaloni, Luca, Andersson, Roland, Andolfi, Enrico, Azfar, Mohammad, Bala, Miklosh, Benkabbou, Amine, Ben-Ishay, Offir, Bianchi, Giorgio, Biffl, Walter L., Brunetti, Francesco, Carra, Maria Clotilde, Casanova, Daniel, Celentano, Valerio, Ceresoli, Marco, Chiara, Osvaldo, Cimbanassi, Stefania, Bini, Roberto, Coimbra, Raul, Luigi deAngelis, Gianm, Decembrino, Francesco, De Palma, Andrea, de Reuver, Philip R., Domingo, Carlos, Cotsoglou, Christian, Ferrero, Alessandro, Fraga, Gustavo P., Gaiani, Federica, Gheza, Federico, Gurrado, Angela, Harrison, Ewen, Henriquez, Angel, Hofmeyr, Stefan, Iadarola, Roberta, Kashuk, Jeffry L., Kianmanesh, Reza, Kirkpatrick, Andrew W., Kluger, Yoram, Landi, Filippo, Langella, Serena, Lapointe, Real, Le Roy, Bertrand, Luciani, Alain, Machado, Fernando, Maggi, Umberto, Maier, Ronald V., Mefire, Alain Chichom, Hiramatsu, Kazuhiro, Ordonez, Carlos, Patrizi, Franca, Planells, Manuel, Peitzman, Andrew B., Pekolj, Juan, Perdigao, Fabiano, Pereira, Bruno M., Pessaux, Patrick, Pisano, Michele, Puyana, Juan Carlos, Rizoli, Sandro, Portigliotti, Luca, Romito, Raffaele, Sakakushev, Boris, Sanei, Behnam, Scatton, Olivier, Serradilla-Martin, Mario, Schneck, Anne-Sophie, Sissoko, Mohammed Lamine, Sobhani, Iradj, ten Broek, Richard P., Testini, Mario, Valinas, Roberto, Veloudis, Giorgos, Vitali, Giulio Cesare, Weber, Dieter, Zorcolo, Luigi, Giuliante, Felice, Gavriilidis, Paschalis, Fuks, David, and Sommacale, Daniele

Abstract

Bile duct injury (BDI) is a dangerous complication of cholecystectomy, with significant postoperative sequelae for the patient in terms of morbidity, mortality, and long-term quality of life. BDIs have an estimated incidence of 0.4-1.5%, but considering the number of cholecystectomies performed worldwide, mostly by laparoscopy, surgeons must be prepared to manage this surgical challenge. Most BDIs are recognized either during the procedure or in the immediate postoperative period. However, some BDIs may be discovered later during the postoperative period, and this may translate to delayed or inappropriate treatments. Providing a specific diagnosis and a precise description of the BDI will expedite the decision-making process and increase the chance of treatment success. Subsequently, the choice and timing of the appropriate reconstructive strategy have a critical role in long-term prognosis. Currently, a wide spectrum of multidisciplinary interventions with different degrees of invasiveness is indicated for BDI management. These World Society of Emergency Surgery (WSES) guidelines have been produced following an exhaustive review of the current literature and an international expert panel discussion with the aim of providing evidence-based recommendations to facilitate and standardize the detection and management of BDIs during cholecystectomy. In particular, the 2020 WSES guidelines cover the following key aspects: (1) strategies to minimize the risk of BDI during cholecystectomy; (2) BDI rates in general surgery units and review of surgical practice; (3) how to classify, stage, and report BDI once detected; (4) how to manage an intraoperatively detected BDI; (5) indications for antibiotic treatment; (6) indications for clinical, biochemical, and imaging investigations for suspected BDI; and (7) how to manage a postoperatively detected BDI.

Published
2021
Full Text
View/download PDF

3. 2020 WSES guidelines for the detection and management of bile duct injury during cholecystectomy

Author

DeAngelis, Nicola, Catena, Fausto, Memeo, Riccardo, Coccolini, Federico, Martinez-Perez, Aleix, Romeo, Oreste M., De Simone, Belinda, Di Saverio, Salomone, Brustia, Raffaele, Rhaiem, Rami, Piardi, Tullio, Conticchio, Maria, Marchegiani, Francesco, Beghdadi, Nassiba, Abu-Zidan, Fikri M., Alikhanov, Ruslan, Allard, Marc-Antoine, Allievi, Niccolo, Amaddeo, Giuliana, Ansaloni, Luca, Andersson, Roland, Andolfi, Enrico, Azfar, Mohammad, Bala, Miklosh, Benkabbou, Amine, Ben-Ishay, Offir, Bianchi, Giorgio, Biffl, Walter L., Brunetti, Francesco, Carra, Maria Clotilde, Casanova, Daniel, Celentano, Valerio, Ceresoli, Marco, Chiara, Osvaldo, Cimbanassi, Stefania, Bini, Roberto, Coimbra, Raul, Luigi deAngelis, Gianm, Decembrino, Francesco, De Palma, Andrea, de Reuver, Philip R., Domingo, Carlos, Cotsoglou, Christian, Ferrero, Alessandro, Fraga, Gustavo P., Gaiani, Federica, Gheza, Federico, Gurrado, Angela, Harrison, Ewen, Henriquez, Angel, Hofmeyr, Stefan, Iadarola, Roberta, Kashuk, Jeffry L., Kianmanesh, Reza, Kirkpatrick, Andrew W., Kluger, Yoram, Landi, Filippo, Langella, Serena, Lapointe, Real, Le Roy, Bertrand, Luciani, Alain, Machado, Fernando, Maggi, Umberto, Maier, Ronald V., Mefire, Alain Chichom, Hiramatsu, Kazuhiro, Ordonez, Carlos, Patrizi, Franca, Planells, Manuel, Peitzman, Andrew B., Pekolj, Juan, Perdigao, Fabiano, Pereira, Bruno M., Pessaux, Patrick, Pisano, Michele, Puyana, Juan Carlos, Rizoli, Sandro, Portigliotti, Luca, Romito, Raffaele, Sakakushev, Boris, Sanei, Behnam, Scatton, Olivier, Serradilla-Martin, Mario, Schneck, Anne-Sophie, Sissoko, Mohammed Lamine, Sobhani, Iradj, ten Broek, Richard P., Testini, Mario, Valinas, Roberto, Veloudis, Giorgos, Vitali, Giulio Cesare, Weber, Dieter, Zorcolo, Luigi, Giuliante, Felice, Gavriilidis, Paschalis, Fuks, David, Sommacale, Daniele, DeAngelis, Nicola, Catena, Fausto, Memeo, Riccardo, Coccolini, Federico, Martinez-Perez, Aleix, Romeo, Oreste M., De Simone, Belinda, Di Saverio, Salomone, Brustia, Raffaele, Rhaiem, Rami, Piardi, Tullio, Conticchio, Maria, Marchegiani, Francesco, Beghdadi, Nassiba, Abu-Zidan, Fikri M., Alikhanov, Ruslan, Allard, Marc-Antoine, Allievi, Niccolo, Amaddeo, Giuliana, Ansaloni, Luca, Andersson, Roland, Andolfi, Enrico, Azfar, Mohammad, Bala, Miklosh, Benkabbou, Amine, Ben-Ishay, Offir, Bianchi, Giorgio, Biffl, Walter L., Brunetti, Francesco, Carra, Maria Clotilde, Casanova, Daniel, Celentano, Valerio, Ceresoli, Marco, Chiara, Osvaldo, Cimbanassi, Stefania, Bini, Roberto, Coimbra, Raul, Luigi deAngelis, Gianm, Decembrino, Francesco, De Palma, Andrea, de Reuver, Philip R., Domingo, Carlos, Cotsoglou, Christian, Ferrero, Alessandro, Fraga, Gustavo P., Gaiani, Federica, Gheza, Federico, Gurrado, Angela, Harrison, Ewen, Henriquez, Angel, Hofmeyr, Stefan, Iadarola, Roberta, Kashuk, Jeffry L., Kianmanesh, Reza, Kirkpatrick, Andrew W., Kluger, Yoram, Landi, Filippo, Langella, Serena, Lapointe, Real, Le Roy, Bertrand, Luciani, Alain, Machado, Fernando, Maggi, Umberto, Maier, Ronald V., Mefire, Alain Chichom, Hiramatsu, Kazuhiro, Ordonez, Carlos, Patrizi, Franca, Planells, Manuel, Peitzman, Andrew B., Pekolj, Juan, Perdigao, Fabiano, Pereira, Bruno M., Pessaux, Patrick, Pisano, Michele, Puyana, Juan Carlos, Rizoli, Sandro, Portigliotti, Luca, Romito, Raffaele, Sakakushev, Boris, Sanei, Behnam, Scatton, Olivier, Serradilla-Martin, Mario, Schneck, Anne-Sophie, Sissoko, Mohammed Lamine, Sobhani, Iradj, ten Broek, Richard P., Testini, Mario, Valinas, Roberto, Veloudis, Giorgos, Vitali, Giulio Cesare, Weber, Dieter, Zorcolo, Luigi, Giuliante, Felice, Gavriilidis, Paschalis, Fuks, David, and Sommacale, Daniele

Abstract

Bile duct injury (BDI) is a dangerous complication of cholecystectomy, with significant postoperative sequelae for the patient in terms of morbidity, mortality, and long-term quality of life. BDIs have an estimated incidence of 0.4-1.5%, but considering the number of cholecystectomies performed worldwide, mostly by laparoscopy, surgeons must be prepared to manage this surgical challenge. Most BDIs are recognized either during the procedure or in the immediate postoperative period. However, some BDIs may be discovered later during the postoperative period, and this may translate to delayed or inappropriate treatments. Providing a specific diagnosis and a precise description of the BDI will expedite the decision-making process and increase the chance of treatment success. Subsequently, the choice and timing of the appropriate reconstructive strategy have a critical role in long-term prognosis. Currently, a wide spectrum of multidisciplinary interventions with different degrees of invasiveness is indicated for BDI management. These World Society of Emergency Surgery (WSES) guidelines have been produced following an exhaustive review of the current literature and an international expert panel discussion with the aim of providing evidence-based recommendations to facilitate and standardize the detection and management of BDIs during cholecystectomy. In particular, the 2020 WSES guidelines cover the following key aspects: (1) strategies to minimize the risk of BDI during cholecystectomy; (2) BDI rates in general surgery units and review of surgical practice; (3) how to classify, stage, and report BDI once detected; (4) how to manage an intraoperatively detected BDI; (5) indications for antibiotic treatment; (6) indications for clinical, biochemical, and imaging investigations for suspected BDI; and (7) how to manage a postoperatively detected BDI.

Published
2021
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4. Do young patients with high clinical suspicion of appendicitis really need cross-sectional imaging? Proceedings from a highly controversial debate among the experts panel of 2020 WSES Jerusalem guidelines

Author

Podda, Mauro, Andersson, Roland, Boermeester, Marja, Coccolini, Federico, Sartelli, Massimo, Moore, Ernest E., Sugrue, Michael, Abu-Zidan, Fikri, Tolonen, Matti, Damaskos, Dimitrios, Kluger, Yoram, Soreide, Kjetil, Pisanu, Adolfo, Augustin, Goran, Latifi, Rifat, Kelly, Michael, Leppaniemi, Ari, Fraga, Gustavo P., Ten Broek, Richard, Tan, Edward, Van Goor, Herry, Chiara, Osvaldo, Maier, Ronald V, Pata, Francesco, De Simone, Belinda, Ordonez, Carlos A., Ansaloni, Luca, Catena, Fausto, Di Saverio, Salomone, Podda, Mauro, Andersson, Roland, Boermeester, Marja, Coccolini, Federico, Sartelli, Massimo, Moore, Ernest E., Sugrue, Michael, Abu-Zidan, Fikri, Tolonen, Matti, Damaskos, Dimitrios, Kluger, Yoram, Soreide, Kjetil, Pisanu, Adolfo, Augustin, Goran, Latifi, Rifat, Kelly, Michael, Leppaniemi, Ari, Fraga, Gustavo P., Ten Broek, Richard, Tan, Edward, Van Goor, Herry, Chiara, Osvaldo, Maier, Ronald V, Pata, Francesco, De Simone, Belinda, Ordonez, Carlos A., Ansaloni, Luca, Catena, Fausto, and Di Saverio, Salomone

Abstract

n/a

Published
2021
Full Text
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5. 2020 WSES guidelines for the detection and management of bile duct injury during cholecystectomy

Author

DeAngelis, Nicola, Catena, Fausto, Memeo, Riccardo, Coccolini, Federico, Martinez-Perez, Aleix, Romeo, Oreste M., De Simone, Belinda, Di Saverio, Salomone, Brustia, Raffaele, Rhaiem, Rami, Piardi, Tullio, Conticchio, Maria, Marchegiani, Francesco, Beghdadi, Nassiba, Abu-Zidan, Fikri M., Alikhanov, Ruslan, Allard, Marc-Antoine, Allievi, Niccolo, Amaddeo, Giuliana, Ansaloni, Luca, Andersson, Roland, Andolfi, Enrico, Azfar, Mohammad, Bala, Miklosh, Benkabbou, Amine, Ben-Ishay, Offir, Bianchi, Giorgio, Biffl, Walter L., Brunetti, Francesco, Carra, Maria Clotilde, Casanova, Daniel, Celentano, Valerio, Ceresoli, Marco, Chiara, Osvaldo, Cimbanassi, Stefania, Bini, Roberto, Coimbra, Raul, Luigi deAngelis, Gianm, Decembrino, Francesco, De Palma, Andrea, de Reuver, Philip R., Domingo, Carlos, Cotsoglou, Christian, Ferrero, Alessandro, Fraga, Gustavo P., Gaiani, Federica, Gheza, Federico, Gurrado, Angela, Harrison, Ewen, Henriquez, Angel, Hofmeyr, Stefan, Iadarola, Roberta, Kashuk, Jeffry L., Kianmanesh, Reza, Kirkpatrick, Andrew W., Kluger, Yoram, Landi, Filippo, Langella, Serena, Lapointe, Real, Le Roy, Bertrand, Luciani, Alain, Machado, Fernando, Maggi, Umberto, Maier, Ronald V., Mefire, Alain Chichom, Hiramatsu, Kazuhiro, Ordonez, Carlos, Patrizi, Franca, Planells, Manuel, Peitzman, Andrew B., Pekolj, Juan, Perdigao, Fabiano, Pereira, Bruno M., Pessaux, Patrick, Pisano, Michele, Puyana, Juan Carlos, Rizoli, Sandro, Portigliotti, Luca, Romito, Raffaele, Sakakushev, Boris, Sanei, Behnam, Scatton, Olivier, Serradilla-Martin, Mario, Schneck, Anne-Sophie, Sissoko, Mohammed Lamine, Sobhani, Iradj, ten Broek, Richard P., Testini, Mario, Valinas, Roberto, Veloudis, Giorgos, Vitali, Giulio Cesare, Weber, Dieter, Zorcolo, Luigi, Giuliante, Felice, Gavriilidis, Paschalis, Fuks, David, Sommacale, Daniele, DeAngelis, Nicola, Catena, Fausto, Memeo, Riccardo, Coccolini, Federico, Martinez-Perez, Aleix, Romeo, Oreste M., De Simone, Belinda, Di Saverio, Salomone, Brustia, Raffaele, Rhaiem, Rami, Piardi, Tullio, Conticchio, Maria, Marchegiani, Francesco, Beghdadi, Nassiba, Abu-Zidan, Fikri M., Alikhanov, Ruslan, Allard, Marc-Antoine, Allievi, Niccolo, Amaddeo, Giuliana, Ansaloni, Luca, Andersson, Roland, Andolfi, Enrico, Azfar, Mohammad, Bala, Miklosh, Benkabbou, Amine, Ben-Ishay, Offir, Bianchi, Giorgio, Biffl, Walter L., Brunetti, Francesco, Carra, Maria Clotilde, Casanova, Daniel, Celentano, Valerio, Ceresoli, Marco, Chiara, Osvaldo, Cimbanassi, Stefania, Bini, Roberto, Coimbra, Raul, Luigi deAngelis, Gianm, Decembrino, Francesco, De Palma, Andrea, de Reuver, Philip R., Domingo, Carlos, Cotsoglou, Christian, Ferrero, Alessandro, Fraga, Gustavo P., Gaiani, Federica, Gheza, Federico, Gurrado, Angela, Harrison, Ewen, Henriquez, Angel, Hofmeyr, Stefan, Iadarola, Roberta, Kashuk, Jeffry L., Kianmanesh, Reza, Kirkpatrick, Andrew W., Kluger, Yoram, Landi, Filippo, Langella, Serena, Lapointe, Real, Le Roy, Bertrand, Luciani, Alain, Machado, Fernando, Maggi, Umberto, Maier, Ronald V., Mefire, Alain Chichom, Hiramatsu, Kazuhiro, Ordonez, Carlos, Patrizi, Franca, Planells, Manuel, Peitzman, Andrew B., Pekolj, Juan, Perdigao, Fabiano, Pereira, Bruno M., Pessaux, Patrick, Pisano, Michele, Puyana, Juan Carlos, Rizoli, Sandro, Portigliotti, Luca, Romito, Raffaele, Sakakushev, Boris, Sanei, Behnam, Scatton, Olivier, Serradilla-Martin, Mario, Schneck, Anne-Sophie, Sissoko, Mohammed Lamine, Sobhani, Iradj, ten Broek, Richard P., Testini, Mario, Valinas, Roberto, Veloudis, Giorgos, Vitali, Giulio Cesare, Weber, Dieter, Zorcolo, Luigi, Giuliante, Felice, Gavriilidis, Paschalis, Fuks, David, and Sommacale, Daniele

Abstract

Bile duct injury (BDI) is a dangerous complication of cholecystectomy, with significant postoperative sequelae for the patient in terms of morbidity, mortality, and long-term quality of life. BDIs have an estimated incidence of 0.4-1.5%, but considering the number of cholecystectomies performed worldwide, mostly by laparoscopy, surgeons must be prepared to manage this surgical challenge. Most BDIs are recognized either during the procedure or in the immediate postoperative period. However, some BDIs may be discovered later during the postoperative period, and this may translate to delayed or inappropriate treatments. Providing a specific diagnosis and a precise description of the BDI will expedite the decision-making process and increase the chance of treatment success. Subsequently, the choice and timing of the appropriate reconstructive strategy have a critical role in long-term prognosis. Currently, a wide spectrum of multidisciplinary interventions with different degrees of invasiveness is indicated for BDI management. These World Society of Emergency Surgery (WSES) guidelines have been produced following an exhaustive review of the current literature and an international expert panel discussion with the aim of providing evidence-based recommendations to facilitate and standardize the detection and management of BDIs during cholecystectomy. In particular, the 2020 WSES guidelines cover the following key aspects: (1) strategies to minimize the risk of BDI during cholecystectomy; (2) BDI rates in general surgery units and review of surgical practice; (3) how to classify, stage, and report BDI once detected; (4) how to manage an intraoperatively detected BDI; (5) indications for antibiotic treatment; (6) indications for clinical, biochemical, and imaging investigations for suspected BDI; and (7) how to manage a postoperatively detected BDI.

Published
2021
Full Text
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6. 2020 WSES guidelines for the detection and management of bile duct injury during cholecystectomy

Author

DeAngelis, Nicola, Catena, Fausto, Memeo, Riccardo, Coccolini, Federico, Martinez-Perez, Aleix, Romeo, Oreste M., De Simone, Belinda, Di Saverio, Salomone, Brustia, Raffaele, Rhaiem, Rami, Piardi, Tullio, Conticchio, Maria, Marchegiani, Francesco, Beghdadi, Nassiba, Abu-Zidan, Fikri M., Alikhanov, Ruslan, Allard, Marc-Antoine, Allievi, Niccolo, Amaddeo, Giuliana, Ansaloni, Luca, Andersson, Roland, Andolfi, Enrico, Azfar, Mohammad, Bala, Miklosh, Benkabbou, Amine, Ben-Ishay, Offir, Bianchi, Giorgio, Biffl, Walter L., Brunetti, Francesco, Carra, Maria Clotilde, Casanova, Daniel, Celentano, Valerio, Ceresoli, Marco, Chiara, Osvaldo, Cimbanassi, Stefania, Bini, Roberto, Coimbra, Raul, Luigi deAngelis, Gianm, Decembrino, Francesco, De Palma, Andrea, de Reuver, Philip R., Domingo, Carlos, Cotsoglou, Christian, Ferrero, Alessandro, Fraga, Gustavo P., Gaiani, Federica, Gheza, Federico, Gurrado, Angela, Harrison, Ewen, Henriquez, Angel, Hofmeyr, Stefan, Iadarola, Roberta, Kashuk, Jeffry L., Kianmanesh, Reza, Kirkpatrick, Andrew W., Kluger, Yoram, Landi, Filippo, Langella, Serena, Lapointe, Real, Le Roy, Bertrand, Luciani, Alain, Machado, Fernando, Maggi, Umberto, Maier, Ronald V., Mefire, Alain Chichom, Hiramatsu, Kazuhiro, Ordonez, Carlos, Patrizi, Franca, Planells, Manuel, Peitzman, Andrew B., Pekolj, Juan, Perdigao, Fabiano, Pereira, Bruno M., Pessaux, Patrick, Pisano, Michele, Puyana, Juan Carlos, Rizoli, Sandro, Portigliotti, Luca, Romito, Raffaele, Sakakushev, Boris, Sanei, Behnam, Scatton, Olivier, Serradilla-Martin, Mario, Schneck, Anne-Sophie, Sissoko, Mohammed Lamine, Sobhani, Iradj, ten Broek, Richard P., Testini, Mario, Valinas, Roberto, Veloudis, Giorgos, Vitali, Giulio Cesare, Weber, Dieter, Zorcolo, Luigi, Giuliante, Felice, Gavriilidis, Paschalis, Fuks, David, Sommacale, Daniele, DeAngelis, Nicola, Catena, Fausto, Memeo, Riccardo, Coccolini, Federico, Martinez-Perez, Aleix, Romeo, Oreste M., De Simone, Belinda, Di Saverio, Salomone, Brustia, Raffaele, Rhaiem, Rami, Piardi, Tullio, Conticchio, Maria, Marchegiani, Francesco, Beghdadi, Nassiba, Abu-Zidan, Fikri M., Alikhanov, Ruslan, Allard, Marc-Antoine, Allievi, Niccolo, Amaddeo, Giuliana, Ansaloni, Luca, Andersson, Roland, Andolfi, Enrico, Azfar, Mohammad, Bala, Miklosh, Benkabbou, Amine, Ben-Ishay, Offir, Bianchi, Giorgio, Biffl, Walter L., Brunetti, Francesco, Carra, Maria Clotilde, Casanova, Daniel, Celentano, Valerio, Ceresoli, Marco, Chiara, Osvaldo, Cimbanassi, Stefania, Bini, Roberto, Coimbra, Raul, Luigi deAngelis, Gianm, Decembrino, Francesco, De Palma, Andrea, de Reuver, Philip R., Domingo, Carlos, Cotsoglou, Christian, Ferrero, Alessandro, Fraga, Gustavo P., Gaiani, Federica, Gheza, Federico, Gurrado, Angela, Harrison, Ewen, Henriquez, Angel, Hofmeyr, Stefan, Iadarola, Roberta, Kashuk, Jeffry L., Kianmanesh, Reza, Kirkpatrick, Andrew W., Kluger, Yoram, Landi, Filippo, Langella, Serena, Lapointe, Real, Le Roy, Bertrand, Luciani, Alain, Machado, Fernando, Maggi, Umberto, Maier, Ronald V., Mefire, Alain Chichom, Hiramatsu, Kazuhiro, Ordonez, Carlos, Patrizi, Franca, Planells, Manuel, Peitzman, Andrew B., Pekolj, Juan, Perdigao, Fabiano, Pereira, Bruno M., Pessaux, Patrick, Pisano, Michele, Puyana, Juan Carlos, Rizoli, Sandro, Portigliotti, Luca, Romito, Raffaele, Sakakushev, Boris, Sanei, Behnam, Scatton, Olivier, Serradilla-Martin, Mario, Schneck, Anne-Sophie, Sissoko, Mohammed Lamine, Sobhani, Iradj, ten Broek, Richard P., Testini, Mario, Valinas, Roberto, Veloudis, Giorgos, Vitali, Giulio Cesare, Weber, Dieter, Zorcolo, Luigi, Giuliante, Felice, Gavriilidis, Paschalis, Fuks, David, and Sommacale, Daniele

Abstract

Bile duct injury (BDI) is a dangerous complication of cholecystectomy, with significant postoperative sequelae for the patient in terms of morbidity, mortality, and long-term quality of life. BDIs have an estimated incidence of 0.4-1.5%, but considering the number of cholecystectomies performed worldwide, mostly by laparoscopy, surgeons must be prepared to manage this surgical challenge. Most BDIs are recognized either during the procedure or in the immediate postoperative period. However, some BDIs may be discovered later during the postoperative period, and this may translate to delayed or inappropriate treatments. Providing a specific diagnosis and a precise description of the BDI will expedite the decision-making process and increase the chance of treatment success. Subsequently, the choice and timing of the appropriate reconstructive strategy have a critical role in long-term prognosis. Currently, a wide spectrum of multidisciplinary interventions with different degrees of invasiveness is indicated for BDI management. These World Society of Emergency Surgery (WSES) guidelines have been produced following an exhaustive review of the current literature and an international expert panel discussion with the aim of providing evidence-based recommendations to facilitate and standardize the detection and management of BDIs during cholecystectomy. In particular, the 2020 WSES guidelines cover the following key aspects: (1) strategies to minimize the risk of BDI during cholecystectomy; (2) BDI rates in general surgery units and review of surgical practice; (3) how to classify, stage, and report BDI once detected; (4) how to manage an intraoperatively detected BDI; (5) indications for antibiotic treatment; (6) indications for clinical, biochemical, and imaging investigations for suspected BDI; and (7) how to manage a postoperatively detected BDI.

Published
2021
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7. Diagnosis and treatment of acute appendicitis: 2020 update of the WSES Jerusalem guidelines

Author

Di Saverio, Salomone, Podda, Mauro, De Simone, Belinda, Ceresoli, Marco, Augustin, Goran, Gori, Alice, Boermeester, Marja, Sartelli, Massimo, Coccolini, Federico, Tarasconi, Antonio, Angelis, Nicola de, Weber, Dieter G., Tolonen, Matti, Birindelli, Arianna, Biffl, Walter, Moore, Ernest E., Kelly, Michael, Soreide, Kjetil, Kashuk, Jeffry, Ten Broek, Richard, Gomes, Carlos Augusto, Sugrue, Michael, Davies, Richard Justin, Damaskos, Dimitrios, Leppaniemi, Ari, Kirkpatrick, Andrew, Peitzman, Andrew B., Fraga, Gustavo P., Maier, Ronald V., Coimbra, Raul, Chiarugi, Massimo, Sganga, Gabriele, Pisanu, Adolfo, Angelis, Gian Luigi de, Tan, Edward, Van Goor, Harry, Pata, Francesco, Di Carlo, Isidoro, Chiara, Osvaldo, Litvin, Andrey, Campanile, Fabio C., Sakakushev, Boris, Tomadze, Gia, Demetrashvili, Zaza, Latifi, Rifat, Abu-Zidan, Fakri, Romeo, Oreste, Segovia-Lohse, Helmut, Baiocchi, Gianluca, Costa, David, Rizoli, Sandro, Balogh, Zsolt J., Bendinelli, Cino, Scalea, Thomas, Ivatury, Rao, Velmahos, George, Andersson, Roland, Kluger, Yoram, Ansaloni, Luca, Catena, Fausto, Di Saverio, Salomone, Podda, Mauro, De Simone, Belinda, Ceresoli, Marco, Augustin, Goran, Gori, Alice, Boermeester, Marja, Sartelli, Massimo, Coccolini, Federico, Tarasconi, Antonio, Angelis, Nicola de, Weber, Dieter G., Tolonen, Matti, Birindelli, Arianna, Biffl, Walter, Moore, Ernest E., Kelly, Michael, Soreide, Kjetil, Kashuk, Jeffry, Ten Broek, Richard, Gomes, Carlos Augusto, Sugrue, Michael, Davies, Richard Justin, Damaskos, Dimitrios, Leppaniemi, Ari, Kirkpatrick, Andrew, Peitzman, Andrew B., Fraga, Gustavo P., Maier, Ronald V., Coimbra, Raul, Chiarugi, Massimo, Sganga, Gabriele, Pisanu, Adolfo, Angelis, Gian Luigi de, Tan, Edward, Van Goor, Harry, Pata, Francesco, Di Carlo, Isidoro, Chiara, Osvaldo, Litvin, Andrey, Campanile, Fabio C., Sakakushev, Boris, Tomadze, Gia, Demetrashvili, Zaza, Latifi, Rifat, Abu-Zidan, Fakri, Romeo, Oreste, Segovia-Lohse, Helmut, Baiocchi, Gianluca, Costa, David, Rizoli, Sandro, Balogh, Zsolt J., Bendinelli, Cino, Scalea, Thomas, Ivatury, Rao, Velmahos, George, Andersson, Roland, Kluger, Yoram, Ansaloni, Luca, and Catena, Fausto

Abstract

Background and aims Acute appendicitis (AA) is among the most common causes of acute abdominal pain. Diagnosis of AA is still challenging and some controversies on its management are still present among different settings and practice patterns worldwide. In July 2015, the World Society of Emergency Surgery (WSES) organized in Jerusalem the first consensus conference on the diagnosis and treatment of AA in adult patients with the intention of producing evidence-based guidelines. An updated consensus conference took place in Nijemegen in June 2019 and the guidelines have now been updated in order to provide evidence-based statements and recommendations in keeping with varying clinical practice: use of clinical scores and imaging in diagnosing AA, indications and timing for surgery, use of non-operative management and antibiotics, laparoscopy and surgical techniques, intra-operative scoring, and peri-operative antibiotic therapy. Methods This executive manuscript summarizes the WSES guidelines for the diagnosis and treatment of AA. Literature search has been updated up to 2019 and statements and recommendations have been developed according to the GRADE methodology. The statements were voted, eventually modified, and finally approved by the participants to the consensus conference and by the board of co-authors, using a Delphi methodology for voting whenever there was controversy on a statement or a recommendation. Several tables highlighting the research topics and questions, search syntaxes, and the statements and the WSES evidence-based recommendations are provided. Finally, two different practical clinical algorithms are provided in the form of a flow chart for both adults and pediatric (< 16 years old) patients. Conclusions The 2020 WSES guidelines on AA aim to provide updated evidence-based statements and recommendations on each of the following topics: (1) diagnosis, (2) non-operative management for uncomplicated AA, (3) timing of appendectomy and in-hosp

Published
2020
Full Text
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8. Diagnosis and treatment of acute appendicitis: 2020 update of the WSES Jerusalem guidelines

Author

Di Saverio, Salomone, Podda, Mauro, De Simone, Belinda, Ceresoli, Marco, Augustin, Goran, Gori, Alice, Boermeester, Marja, Sartelli, Massimo, Coccolini, Federico, Tarasconi, Antonio, Angelis, Nicola de, Weber, Dieter G., Tolonen, Matti, Birindelli, Arianna, Biffl, Walter, Moore, Ernest E., Kelly, Michael, Soreide, Kjetil, Kashuk, Jeffry, Ten Broek, Richard, Gomes, Carlos Augusto, Sugrue, Michael, Davies, Richard Justin, Damaskos, Dimitrios, Leppaniemi, Ari, Kirkpatrick, Andrew, Peitzman, Andrew B., Fraga, Gustavo P., Maier, Ronald V., Coimbra, Raul, Chiarugi, Massimo, Sganga, Gabriele, Pisanu, Adolfo, Angelis, Gian Luigi de, Tan, Edward, Van Goor, Harry, Pata, Francesco, Di Carlo, Isidoro, Chiara, Osvaldo, Litvin, Andrey, Campanile, Fabio C., Sakakushev, Boris, Tomadze, Gia, Demetrashvili, Zaza, Latifi, Rifat, Abu-Zidan, Fakri, Romeo, Oreste, Segovia-Lohse, Helmut, Baiocchi, Gianluca, Costa, David, Rizoli, Sandro, Balogh, Zsolt J., Bendinelli, Cino, Scalea, Thomas, Ivatury, Rao, Velmahos, George, Andersson, Roland, Kluger, Yoram, Ansaloni, Luca, Catena, Fausto, Di Saverio, Salomone, Podda, Mauro, De Simone, Belinda, Ceresoli, Marco, Augustin, Goran, Gori, Alice, Boermeester, Marja, Sartelli, Massimo, Coccolini, Federico, Tarasconi, Antonio, Angelis, Nicola de, Weber, Dieter G., Tolonen, Matti, Birindelli, Arianna, Biffl, Walter, Moore, Ernest E., Kelly, Michael, Soreide, Kjetil, Kashuk, Jeffry, Ten Broek, Richard, Gomes, Carlos Augusto, Sugrue, Michael, Davies, Richard Justin, Damaskos, Dimitrios, Leppaniemi, Ari, Kirkpatrick, Andrew, Peitzman, Andrew B., Fraga, Gustavo P., Maier, Ronald V., Coimbra, Raul, Chiarugi, Massimo, Sganga, Gabriele, Pisanu, Adolfo, Angelis, Gian Luigi de, Tan, Edward, Van Goor, Harry, Pata, Francesco, Di Carlo, Isidoro, Chiara, Osvaldo, Litvin, Andrey, Campanile, Fabio C., Sakakushev, Boris, Tomadze, Gia, Demetrashvili, Zaza, Latifi, Rifat, Abu-Zidan, Fakri, Romeo, Oreste, Segovia-Lohse, Helmut, Baiocchi, Gianluca, Costa, David, Rizoli, Sandro, Balogh, Zsolt J., Bendinelli, Cino, Scalea, Thomas, Ivatury, Rao, Velmahos, George, Andersson, Roland, Kluger, Yoram, Ansaloni, Luca, and Catena, Fausto

Abstract

Background and aims Acute appendicitis (AA) is among the most common causes of acute abdominal pain. Diagnosis of AA is still challenging and some controversies on its management are still present among different settings and practice patterns worldwide. In July 2015, the World Society of Emergency Surgery (WSES) organized in Jerusalem the first consensus conference on the diagnosis and treatment of AA in adult patients with the intention of producing evidence-based guidelines. An updated consensus conference took place in Nijemegen in June 2019 and the guidelines have now been updated in order to provide evidence-based statements and recommendations in keeping with varying clinical practice: use of clinical scores and imaging in diagnosing AA, indications and timing for surgery, use of non-operative management and antibiotics, laparoscopy and surgical techniques, intra-operative scoring, and peri-operative antibiotic therapy. Methods This executive manuscript summarizes the WSES guidelines for the diagnosis and treatment of AA. Literature search has been updated up to 2019 and statements and recommendations have been developed according to the GRADE methodology. The statements were voted, eventually modified, and finally approved by the participants to the consensus conference and by the board of co-authors, using a Delphi methodology for voting whenever there was controversy on a statement or a recommendation. Several tables highlighting the research topics and questions, search syntaxes, and the statements and the WSES evidence-based recommendations are provided. Finally, two different practical clinical algorithms are provided in the form of a flow chart for both adults and pediatric (< 16 years old) patients. Conclusions The 2020 WSES guidelines on AA aim to provide updated evidence-based statements and recommendations on each of the following topics: (1) diagnosis, (2) non-operative management for uncomplicated AA, (3) timing of appendectomy and in-hosp

Published
2020
Full Text
View/download PDF

9. Diagnosis and treatment of acute appendicitis: 2020 update of the WSES Jerusalem guidelines

Author

Di Saverio, Salomone, Podda, Mauro, De Simone, Belinda, Ceresoli, Marco, Augustin, Goran, Gori, Alice, Boermeester, Marja, Sartelli, Massimo, Coccolini, Federico, Tarasconi, Antonio, Angelis, Nicola de, Weber, Dieter G., Tolonen, Matti, Birindelli, Arianna, Biffl, Walter, Moore, Ernest E., Kelly, Michael, Soreide, Kjetil, Kashuk, Jeffry, Ten Broek, Richard, Gomes, Carlos Augusto, Sugrue, Michael, Davies, Richard Justin, Damaskos, Dimitrios, Leppaniemi, Ari, Kirkpatrick, Andrew, Peitzman, Andrew B., Fraga, Gustavo P., Maier, Ronald V., Coimbra, Raul, Chiarugi, Massimo, Sganga, Gabriele, Pisanu, Adolfo, Angelis, Gian Luigi de, Tan, Edward, Van Goor, Harry, Pata, Francesco, Di Carlo, Isidoro, Chiara, Osvaldo, Litvin, Andrey, Campanile, Fabio C., Sakakushev, Boris, Tomadze, Gia, Demetrashvili, Zaza, Latifi, Rifat, Abu-Zidan, Fakri, Romeo, Oreste, Segovia-Lohse, Helmut, Baiocchi, Gianluca, Costa, David, Rizoli, Sandro, Balogh, Zsolt J., Bendinelli, Cino, Scalea, Thomas, Ivatury, Rao, Velmahos, George, Andersson, Roland, Kluger, Yoram, Ansaloni, Luca, Catena, Fausto, Di Saverio, Salomone, Podda, Mauro, De Simone, Belinda, Ceresoli, Marco, Augustin, Goran, Gori, Alice, Boermeester, Marja, Sartelli, Massimo, Coccolini, Federico, Tarasconi, Antonio, Angelis, Nicola de, Weber, Dieter G., Tolonen, Matti, Birindelli, Arianna, Biffl, Walter, Moore, Ernest E., Kelly, Michael, Soreide, Kjetil, Kashuk, Jeffry, Ten Broek, Richard, Gomes, Carlos Augusto, Sugrue, Michael, Davies, Richard Justin, Damaskos, Dimitrios, Leppaniemi, Ari, Kirkpatrick, Andrew, Peitzman, Andrew B., Fraga, Gustavo P., Maier, Ronald V., Coimbra, Raul, Chiarugi, Massimo, Sganga, Gabriele, Pisanu, Adolfo, Angelis, Gian Luigi de, Tan, Edward, Van Goor, Harry, Pata, Francesco, Di Carlo, Isidoro, Chiara, Osvaldo, Litvin, Andrey, Campanile, Fabio C., Sakakushev, Boris, Tomadze, Gia, Demetrashvili, Zaza, Latifi, Rifat, Abu-Zidan, Fakri, Romeo, Oreste, Segovia-Lohse, Helmut, Baiocchi, Gianluca, Costa, David, Rizoli, Sandro, Balogh, Zsolt J., Bendinelli, Cino, Scalea, Thomas, Ivatury, Rao, Velmahos, George, Andersson, Roland, Kluger, Yoram, Ansaloni, Luca, and Catena, Fausto

Abstract

Background and aims Acute appendicitis (AA) is among the most common causes of acute abdominal pain. Diagnosis of AA is still challenging and some controversies on its management are still present among different settings and practice patterns worldwide. In July 2015, the World Society of Emergency Surgery (WSES) organized in Jerusalem the first consensus conference on the diagnosis and treatment of AA in adult patients with the intention of producing evidence-based guidelines. An updated consensus conference took place in Nijemegen in June 2019 and the guidelines have now been updated in order to provide evidence-based statements and recommendations in keeping with varying clinical practice: use of clinical scores and imaging in diagnosing AA, indications and timing for surgery, use of non-operative management and antibiotics, laparoscopy and surgical techniques, intra-operative scoring, and peri-operative antibiotic therapy. Methods This executive manuscript summarizes the WSES guidelines for the diagnosis and treatment of AA. Literature search has been updated up to 2019 and statements and recommendations have been developed according to the GRADE methodology. The statements were voted, eventually modified, and finally approved by the participants to the consensus conference and by the board of co-authors, using a Delphi methodology for voting whenever there was controversy on a statement or a recommendation. Several tables highlighting the research topics and questions, search syntaxes, and the statements and the WSES evidence-based recommendations are provided. Finally, two different practical clinical algorithms are provided in the form of a flow chart for both adults and pediatric (< 16 years old) patients. Conclusions The 2020 WSES guidelines on AA aim to provide updated evidence-based statements and recommendations on each of the following topics: (1) diagnosis, (2) non-operative management for uncomplicated AA, (3) timing of appendectomy and in-hosp

Published
2020
Full Text
View/download PDF

10. Diagnosis and treatment of acute appendicitis: 2020 update of the WSES Jerusalem guidelines

Author

Di Saverio, Salomone, Podda, Mauro, De Simone, Belinda, Ceresoli, Marco, Augustin, Goran, Gori, Alice, Boermeester, Marja, Sartelli, Massimo, Coccolini, Federico, Tarasconi, Antonio, Angelis, Nicola de, Weber, Dieter G., Tolonen, Matti, Birindelli, Arianna, Biffl, Walter, Moore, Ernest E., Kelly, Michael, Soreide, Kjetil, Kashuk, Jeffry, Ten Broek, Richard, Gomes, Carlos Augusto, Sugrue, Michael, Davies, Richard Justin, Damaskos, Dimitrios, Leppaniemi, Ari, Kirkpatrick, Andrew, Peitzman, Andrew B., Fraga, Gustavo P., Maier, Ronald V., Coimbra, Raul, Chiarugi, Massimo, Sganga, Gabriele, Pisanu, Adolfo, Angelis, Gian Luigi de, Tan, Edward, Van Goor, Harry, Pata, Francesco, Di Carlo, Isidoro, Chiara, Osvaldo, Litvin, Andrey, Campanile, Fabio C., Sakakushev, Boris, Tomadze, Gia, Demetrashvili, Zaza, Latifi, Rifat, Abu-Zidan, Fakri, Romeo, Oreste, Segovia-Lohse, Helmut, Baiocchi, Gianluca, Costa, David, Rizoli, Sandro, Balogh, Zsolt J., Bendinelli, Cino, Scalea, Thomas, Ivatury, Rao, Velmahos, George, Andersson, Roland, Kluger, Yoram, Ansaloni, Luca, Catena, Fausto, Di Saverio, Salomone, Podda, Mauro, De Simone, Belinda, Ceresoli, Marco, Augustin, Goran, Gori, Alice, Boermeester, Marja, Sartelli, Massimo, Coccolini, Federico, Tarasconi, Antonio, Angelis, Nicola de, Weber, Dieter G., Tolonen, Matti, Birindelli, Arianna, Biffl, Walter, Moore, Ernest E., Kelly, Michael, Soreide, Kjetil, Kashuk, Jeffry, Ten Broek, Richard, Gomes, Carlos Augusto, Sugrue, Michael, Davies, Richard Justin, Damaskos, Dimitrios, Leppaniemi, Ari, Kirkpatrick, Andrew, Peitzman, Andrew B., Fraga, Gustavo P., Maier, Ronald V., Coimbra, Raul, Chiarugi, Massimo, Sganga, Gabriele, Pisanu, Adolfo, Angelis, Gian Luigi de, Tan, Edward, Van Goor, Harry, Pata, Francesco, Di Carlo, Isidoro, Chiara, Osvaldo, Litvin, Andrey, Campanile, Fabio C., Sakakushev, Boris, Tomadze, Gia, Demetrashvili, Zaza, Latifi, Rifat, Abu-Zidan, Fakri, Romeo, Oreste, Segovia-Lohse, Helmut, Baiocchi, Gianluca, Costa, David, Rizoli, Sandro, Balogh, Zsolt J., Bendinelli, Cino, Scalea, Thomas, Ivatury, Rao, Velmahos, George, Andersson, Roland, Kluger, Yoram, Ansaloni, Luca, and Catena, Fausto

Abstract

Background and aims Acute appendicitis (AA) is among the most common causes of acute abdominal pain. Diagnosis of AA is still challenging and some controversies on its management are still present among different settings and practice patterns worldwide. In July 2015, the World Society of Emergency Surgery (WSES) organized in Jerusalem the first consensus conference on the diagnosis and treatment of AA in adult patients with the intention of producing evidence-based guidelines. An updated consensus conference took place in Nijemegen in June 2019 and the guidelines have now been updated in order to provide evidence-based statements and recommendations in keeping with varying clinical practice: use of clinical scores and imaging in diagnosing AA, indications and timing for surgery, use of non-operative management and antibiotics, laparoscopy and surgical techniques, intra-operative scoring, and peri-operative antibiotic therapy. Methods This executive manuscript summarizes the WSES guidelines for the diagnosis and treatment of AA. Literature search has been updated up to 2019 and statements and recommendations have been developed according to the GRADE methodology. The statements were voted, eventually modified, and finally approved by the participants to the consensus conference and by the board of co-authors, using a Delphi methodology for voting whenever there was controversy on a statement or a recommendation. Several tables highlighting the research topics and questions, search syntaxes, and the statements and the WSES evidence-based recommendations are provided. Finally, two different practical clinical algorithms are provided in the form of a flow chart for both adults and pediatric (< 16 years old) patients. Conclusions The 2020 WSES guidelines on AA aim to provide updated evidence-based statements and recommendations on each of the following topics: (1) diagnosis, (2) non-operative management for uncomplicated AA, (3) timing of appendectomy and in-hosp

Published
2020
Full Text
View/download PDF

11. Diagnosis and treatment of acute appendicitis: 2020 update of the WSES Jerusalem guidelines

Author

Di Saverio, Salomone, Podda, Mauro, De Simone, Belinda, Ceresoli, Marco, Augustin, Goran, Gori, Alice, Boermeester, Marja, Sartelli, Massimo, Coccolini, Federico, Tarasconi, Antonio, Angelis, Nicola de, Weber, Dieter G., Tolonen, Matti, Birindelli, Arianna, Biffl, Walter, Moore, Ernest E., Kelly, Michael, Soreide, Kjetil, Kashuk, Jeffry, Ten Broek, Richard, Gomes, Carlos Augusto, Sugrue, Michael, Davies, Richard Justin, Damaskos, Dimitrios, Leppaniemi, Ari, Kirkpatrick, Andrew, Peitzman, Andrew B., Fraga, Gustavo P., Maier, Ronald V., Coimbra, Raul, Chiarugi, Massimo, Sganga, Gabriele, Pisanu, Adolfo, Angelis, Gian Luigi de, Tan, Edward, Van Goor, Harry, Pata, Francesco, Di Carlo, Isidoro, Chiara, Osvaldo, Litvin, Andrey, Campanile, Fabio C., Sakakushev, Boris, Tomadze, Gia, Demetrashvili, Zaza, Latifi, Rifat, Abu-Zidan, Fakri, Romeo, Oreste, Segovia-Lohse, Helmut, Baiocchi, Gianluca, Costa, David, Rizoli, Sandro, Balogh, Zsolt J., Bendinelli, Cino, Scalea, Thomas, Ivatury, Rao, Velmahos, George, Andersson, Roland, Kluger, Yoram, Ansaloni, Luca, Catena, Fausto, Di Saverio, Salomone, Podda, Mauro, De Simone, Belinda, Ceresoli, Marco, Augustin, Goran, Gori, Alice, Boermeester, Marja, Sartelli, Massimo, Coccolini, Federico, Tarasconi, Antonio, Angelis, Nicola de, Weber, Dieter G., Tolonen, Matti, Birindelli, Arianna, Biffl, Walter, Moore, Ernest E., Kelly, Michael, Soreide, Kjetil, Kashuk, Jeffry, Ten Broek, Richard, Gomes, Carlos Augusto, Sugrue, Michael, Davies, Richard Justin, Damaskos, Dimitrios, Leppaniemi, Ari, Kirkpatrick, Andrew, Peitzman, Andrew B., Fraga, Gustavo P., Maier, Ronald V., Coimbra, Raul, Chiarugi, Massimo, Sganga, Gabriele, Pisanu, Adolfo, Angelis, Gian Luigi de, Tan, Edward, Van Goor, Harry, Pata, Francesco, Di Carlo, Isidoro, Chiara, Osvaldo, Litvin, Andrey, Campanile, Fabio C., Sakakushev, Boris, Tomadze, Gia, Demetrashvili, Zaza, Latifi, Rifat, Abu-Zidan, Fakri, Romeo, Oreste, Segovia-Lohse, Helmut, Baiocchi, Gianluca, Costa, David, Rizoli, Sandro, Balogh, Zsolt J., Bendinelli, Cino, Scalea, Thomas, Ivatury, Rao, Velmahos, George, Andersson, Roland, Kluger, Yoram, Ansaloni, Luca, and Catena, Fausto

Abstract

Background and aims Acute appendicitis (AA) is among the most common causes of acute abdominal pain. Diagnosis of AA is still challenging and some controversies on its management are still present among different settings and practice patterns worldwide. In July 2015, the World Society of Emergency Surgery (WSES) organized in Jerusalem the first consensus conference on the diagnosis and treatment of AA in adult patients with the intention of producing evidence-based guidelines. An updated consensus conference took place in Nijemegen in June 2019 and the guidelines have now been updated in order to provide evidence-based statements and recommendations in keeping with varying clinical practice: use of clinical scores and imaging in diagnosing AA, indications and timing for surgery, use of non-operative management and antibiotics, laparoscopy and surgical techniques, intra-operative scoring, and peri-operative antibiotic therapy. Methods This executive manuscript summarizes the WSES guidelines for the diagnosis and treatment of AA. Literature search has been updated up to 2019 and statements and recommendations have been developed according to the GRADE methodology. The statements were voted, eventually modified, and finally approved by the participants to the consensus conference and by the board of co-authors, using a Delphi methodology for voting whenever there was controversy on a statement or a recommendation. Several tables highlighting the research topics and questions, search syntaxes, and the statements and the WSES evidence-based recommendations are provided. Finally, two different practical clinical algorithms are provided in the form of a flow chart for both adults and pediatric (< 16 years old) patients. Conclusions The 2020 WSES guidelines on AA aim to provide updated evidence-based statements and recommendations on each of the following topics: (1) diagnosis, (2) non-operative management for uncomplicated AA, (3) timing of appendectomy and in-hosp

Published
2020
Full Text
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12. WSES Jerusalem guidelines for diagnosis and treatment of acute appendicitis

Author

Di Saverio, Salomone, Birindelli, Arianna, Kelly, Micheal D., Catena, Fausto, Weber, Dieter G., Sartelli, Massimo, Sugrue, Michael, De Moya, Mark, Augusto Gomes, Carlos, Bhangu, Aneel, Agresta, Ferdinando, Moore, Ernest E., Soreide, Kjetil, Griffiths, Ewen, De Castro, Steve, Kashuk, Jeffry, Kluger, Yoram, Leppaniemi, Ari, Ansaloni, Luca, Andersson, Manne, Coccolini, Federico, Coimbra, Raul, Gurusamy, Kurinchi S., Cesare Campanile, Fabio, Biffl, Walter, Chiara, Osvaldo, Moore, Fred, Peitzman, Andrew B., Fraga, Gustavo P., Costa, David, Maier, Ronald V., Rizoli, Sandro, Balogh, Zsolt J., Bendinelli, Cino, Cirocchi, Roberto, Tonini, Valeria, Piccinini, Alice, Tugnoli, Gregorio, Jovine, Elio, Persiani, Roberto, Biondi, Antonio, Scalea, Thomas, Stahel, Philip, Ivatury, Rao, Velmahos, George, Andersson, Roland, Di Saverio, Salomone, Birindelli, Arianna, Kelly, Micheal D., Catena, Fausto, Weber, Dieter G., Sartelli, Massimo, Sugrue, Michael, De Moya, Mark, Augusto Gomes, Carlos, Bhangu, Aneel, Agresta, Ferdinando, Moore, Ernest E., Soreide, Kjetil, Griffiths, Ewen, De Castro, Steve, Kashuk, Jeffry, Kluger, Yoram, Leppaniemi, Ari, Ansaloni, Luca, Andersson, Manne, Coccolini, Federico, Coimbra, Raul, Gurusamy, Kurinchi S., Cesare Campanile, Fabio, Biffl, Walter, Chiara, Osvaldo, Moore, Fred, Peitzman, Andrew B., Fraga, Gustavo P., Costa, David, Maier, Ronald V., Rizoli, Sandro, Balogh, Zsolt J., Bendinelli, Cino, Cirocchi, Roberto, Tonini, Valeria, Piccinini, Alice, Tugnoli, Gregorio, Jovine, Elio, Persiani, Roberto, Biondi, Antonio, Scalea, Thomas, Stahel, Philip, Ivatury, Rao, Velmahos, George, and Andersson, Roland

Abstract

Acute appendicitis (AA) is among the most common cause of acute abdominal pain. Diagnosis of AA is challenging; a variable combination of clinical signs and symptoms has been used together with laboratory findings in several scoring systems proposed for suggesting the probability of AA and the possible subsequent management pathway. The role of imaging in the diagnosis of AA is still debated, with variable use of US, CT and MRI in different settings worldwide. Up to date, comprehensive clinical guidelines for diagnosis and management of AA have never been issued. In July 2015, during the 3rd World Congress of the WSES, held in Jerusalem (Israel), a panel of experts including an Organizational Committee and Scientific Committee and Scientific Secretariat, participated to a Consensus Conference where eight panelists presented a number of statements developed for each of the eight main questions about diagnosis and management of AA. The statements were then voted, eventually modified and finally approved by the participants to The Consensus Conference and lately by the board of co-authors. The current paper is reporting the definitive Guidelines Statements on each of the following topics: 1) Diagnostic efficiency of clinical scoring systems, 2) Role of Imaging, 3) Non-operative treatment for uncomplicated appendicitis, 4) Timing of appendectomy and in-hospital delay, 5) Surgical treatment 6) Scoring systems for intra-operative grading of appendicitis and their clinical usefulness 7) Non-surgical treatment for complicated appendicitis: abscess or phlegmon 8) Pre-operative and post-operative antibiotics.

Published
2016
Full Text
View/download PDF

13. WSES Jerusalem guidelines for diagnosis and treatment of acute appendicitis

Author

Di Saverio, Salomone, Birindelli, Arianna, Kelly, Micheal D., Catena, Fausto, Weber, Dieter G., Sartelli, Massimo, Sugrue, Michael, De Moya, Mark, Augusto Gomes, Carlos, Bhangu, Aneel, Agresta, Ferdinando, Moore, Ernest E., Soreide, Kjetil, Griffiths, Ewen, De Castro, Steve, Kashuk, Jeffry, Kluger, Yoram, Leppaniemi, Ari, Ansaloni, Luca, Andersson, Manne, Coccolini, Federico, Coimbra, Raul, Gurusamy, Kurinchi S., Cesare Campanile, Fabio, Biffl, Walter, Chiara, Osvaldo, Moore, Fred, Peitzman, Andrew B., Fraga, Gustavo P., Costa, David, Maier, Ronald V., Rizoli, Sandro, Balogh, Zsolt J., Bendinelli, Cino, Cirocchi, Roberto, Tonini, Valeria, Piccinini, Alice, Tugnoli, Gregorio, Jovine, Elio, Persiani, Roberto, Biondi, Antonio, Scalea, Thomas, Stahel, Philip, Ivatury, Rao, Velmahos, George, Andersson, Roland, Di Saverio, Salomone, Birindelli, Arianna, Kelly, Micheal D., Catena, Fausto, Weber, Dieter G., Sartelli, Massimo, Sugrue, Michael, De Moya, Mark, Augusto Gomes, Carlos, Bhangu, Aneel, Agresta, Ferdinando, Moore, Ernest E., Soreide, Kjetil, Griffiths, Ewen, De Castro, Steve, Kashuk, Jeffry, Kluger, Yoram, Leppaniemi, Ari, Ansaloni, Luca, Andersson, Manne, Coccolini, Federico, Coimbra, Raul, Gurusamy, Kurinchi S., Cesare Campanile, Fabio, Biffl, Walter, Chiara, Osvaldo, Moore, Fred, Peitzman, Andrew B., Fraga, Gustavo P., Costa, David, Maier, Ronald V., Rizoli, Sandro, Balogh, Zsolt J., Bendinelli, Cino, Cirocchi, Roberto, Tonini, Valeria, Piccinini, Alice, Tugnoli, Gregorio, Jovine, Elio, Persiani, Roberto, Biondi, Antonio, Scalea, Thomas, Stahel, Philip, Ivatury, Rao, Velmahos, George, and Andersson, Roland

Abstract

Acute appendicitis (AA) is among the most common cause of acute abdominal pain. Diagnosis of AA is challenging; a variable combination of clinical signs and symptoms has been used together with laboratory findings in several scoring systems proposed for suggesting the probability of AA and the possible subsequent management pathway. The role of imaging in the diagnosis of AA is still debated, with variable use of US, CT and MRI in different settings worldwide. Up to date, comprehensive clinical guidelines for diagnosis and management of AA have never been issued. In July 2015, during the 3rd World Congress of the WSES, held in Jerusalem (Israel), a panel of experts including an Organizational Committee and Scientific Committee and Scientific Secretariat, participated to a Consensus Conference where eight panelists presented a number of statements developed for each of the eight main questions about diagnosis and management of AA. The statements were then voted, eventually modified and finally approved by the participants to The Consensus Conference and lately by the board of co-authors. The current paper is reporting the definitive Guidelines Statements on each of the following topics: 1) Diagnostic efficiency of clinical scoring systems, 2) Role of Imaging, 3) Non-operative treatment for uncomplicated appendicitis, 4) Timing of appendectomy and in-hospital delay, 5) Surgical treatment 6) Scoring systems for intra-operative grading of appendicitis and their clinical usefulness 7) Non-surgical treatment for complicated appendicitis: abscess or phlegmon 8) Pre-operative and post-operative antibiotics.

Published
2016
Full Text
View/download PDF

14. WSES Jerusalem guidelines for diagnosis and treatment of acute appendicitis

Author

Di Saverio, Salomone, Birindelli, Arianna, Kelly, Micheal D., Catena, Fausto, Weber, Dieter G., Sartelli, Massimo, Sugrue, Michael, De Moya, Mark, Augusto Gomes, Carlos, Bhangu, Aneel, Agresta, Ferdinando, Moore, Ernest E., Soreide, Kjetil, Griffiths, Ewen, De Castro, Steve, Kashuk, Jeffry, Kluger, Yoram, Leppaniemi, Ari, Ansaloni, Luca, Andersson, Manne, Coccolini, Federico, Coimbra, Raul, Gurusamy, Kurinchi S., Cesare Campanile, Fabio, Biffl, Walter, Chiara, Osvaldo, Moore, Fred, Peitzman, Andrew B., Fraga, Gustavo P., Costa, David, Maier, Ronald V., Rizoli, Sandro, Balogh, Zsolt J., Bendinelli, Cino, Cirocchi, Roberto, Tonini, Valeria, Piccinini, Alice, Tugnoli, Gregorio, Jovine, Elio, Persiani, Roberto, Biondi, Antonio, Scalea, Thomas, Stahel, Philip, Ivatury, Rao, Velmahos, George, Andersson, Roland, Di Saverio, Salomone, Birindelli, Arianna, Kelly, Micheal D., Catena, Fausto, Weber, Dieter G., Sartelli, Massimo, Sugrue, Michael, De Moya, Mark, Augusto Gomes, Carlos, Bhangu, Aneel, Agresta, Ferdinando, Moore, Ernest E., Soreide, Kjetil, Griffiths, Ewen, De Castro, Steve, Kashuk, Jeffry, Kluger, Yoram, Leppaniemi, Ari, Ansaloni, Luca, Andersson, Manne, Coccolini, Federico, Coimbra, Raul, Gurusamy, Kurinchi S., Cesare Campanile, Fabio, Biffl, Walter, Chiara, Osvaldo, Moore, Fred, Peitzman, Andrew B., Fraga, Gustavo P., Costa, David, Maier, Ronald V., Rizoli, Sandro, Balogh, Zsolt J., Bendinelli, Cino, Cirocchi, Roberto, Tonini, Valeria, Piccinini, Alice, Tugnoli, Gregorio, Jovine, Elio, Persiani, Roberto, Biondi, Antonio, Scalea, Thomas, Stahel, Philip, Ivatury, Rao, Velmahos, George, and Andersson, Roland

Abstract

Acute appendicitis (AA) is among the most common cause of acute abdominal pain. Diagnosis of AA is challenging; a variable combination of clinical signs and symptoms has been used together with laboratory findings in several scoring systems proposed for suggesting the probability of AA and the possible subsequent management pathway. The role of imaging in the diagnosis of AA is still debated, with variable use of US, CT and MRI in different settings worldwide. Up to date, comprehensive clinical guidelines for diagnosis and management of AA have never been issued. In July 2015, during the 3rd World Congress of the WSES, held in Jerusalem (Israel), a panel of experts including an Organizational Committee and Scientific Committee and Scientific Secretariat, participated to a Consensus Conference where eight panelists presented a number of statements developed for each of the eight main questions about diagnosis and management of AA. The statements were then voted, eventually modified and finally approved by the participants to The Consensus Conference and lately by the board of co-authors. The current paper is reporting the definitive Guidelines Statements on each of the following topics: 1) Diagnostic efficiency of clinical scoring systems, 2) Role of Imaging, 3) Non-operative treatment for uncomplicated appendicitis, 4) Timing of appendectomy and in-hospital delay, 5) Surgical treatment 6) Scoring systems for intra-operative grading of appendicitis and their clinical usefulness 7) Non-surgical treatment for complicated appendicitis: abscess or phlegmon 8) Pre-operative and post-operative antibiotics.

Published
2016
Full Text
View/download PDF

15. WSES Jerusalem guidelines for diagnosis and treatment of acute appendicitis

Author

Di Saverio, Salomone, Birindelli, Arianna, Kelly, Micheal D., Catena, Fausto, Weber, Dieter G., Sartelli, Massimo, Sugrue, Michael, De Moya, Mark, Augusto Gomes, Carlos, Bhangu, Aneel, Agresta, Ferdinando, Moore, Ernest E., Soreide, Kjetil, Griffiths, Ewen, De Castro, Steve, Kashuk, Jeffry, Kluger, Yoram, Leppaniemi, Ari, Ansaloni, Luca, Andersson, Manne, Coccolini, Federico, Coimbra, Raul, Gurusamy, Kurinchi S., Cesare Campanile, Fabio, Biffl, Walter, Chiara, Osvaldo, Moore, Fred, Peitzman, Andrew B., Fraga, Gustavo P., Costa, David, Maier, Ronald V., Rizoli, Sandro, Balogh, Zsolt J., Bendinelli, Cino, Cirocchi, Roberto, Tonini, Valeria, Piccinini, Alice, Tugnoli, Gregorio, Jovine, Elio, Persiani, Roberto, Biondi, Antonio, Scalea, Thomas, Stahel, Philip, Ivatury, Rao, Velmahos, George, Andersson, Roland, Di Saverio, Salomone, Birindelli, Arianna, Kelly, Micheal D., Catena, Fausto, Weber, Dieter G., Sartelli, Massimo, Sugrue, Michael, De Moya, Mark, Augusto Gomes, Carlos, Bhangu, Aneel, Agresta, Ferdinando, Moore, Ernest E., Soreide, Kjetil, Griffiths, Ewen, De Castro, Steve, Kashuk, Jeffry, Kluger, Yoram, Leppaniemi, Ari, Ansaloni, Luca, Andersson, Manne, Coccolini, Federico, Coimbra, Raul, Gurusamy, Kurinchi S., Cesare Campanile, Fabio, Biffl, Walter, Chiara, Osvaldo, Moore, Fred, Peitzman, Andrew B., Fraga, Gustavo P., Costa, David, Maier, Ronald V., Rizoli, Sandro, Balogh, Zsolt J., Bendinelli, Cino, Cirocchi, Roberto, Tonini, Valeria, Piccinini, Alice, Tugnoli, Gregorio, Jovine, Elio, Persiani, Roberto, Biondi, Antonio, Scalea, Thomas, Stahel, Philip, Ivatury, Rao, Velmahos, George, and Andersson, Roland

Abstract

Acute appendicitis (AA) is among the most common cause of acute abdominal pain. Diagnosis of AA is challenging; a variable combination of clinical signs and symptoms has been used together with laboratory findings in several scoring systems proposed for suggesting the probability of AA and the possible subsequent management pathway. The role of imaging in the diagnosis of AA is still debated, with variable use of US, CT and MRI in different settings worldwide. Up to date, comprehensive clinical guidelines for diagnosis and management of AA have never been issued. In July 2015, during the 3rd World Congress of the WSES, held in Jerusalem (Israel), a panel of experts including an Organizational Committee and Scientific Committee and Scientific Secretariat, participated to a Consensus Conference where eight panelists presented a number of statements developed for each of the eight main questions about diagnosis and management of AA. The statements were then voted, eventually modified and finally approved by the participants to The Consensus Conference and lately by the board of co-authors. The current paper is reporting the definitive Guidelines Statements on each of the following topics: 1) Diagnostic efficiency of clinical scoring systems, 2) Role of Imaging, 3) Non-operative treatment for uncomplicated appendicitis, 4) Timing of appendectomy and in-hospital delay, 5) Surgical treatment 6) Scoring systems for intra-operative grading of appendicitis and their clinical usefulness 7) Non-surgical treatment for complicated appendicitis: abscess or phlegmon 8) Pre-operative and post-operative antibiotics.

Published
2016
Full Text
View/download PDF

16. WSES Jerusalem guidelines for diagnosis and treatment of acute appendicitis

Author

Di Saverio, Salomone, Birindelli, Arianna, Kelly, Micheal D., Catena, Fausto, Weber, Dieter G., Sartelli, Massimo, Sugrue, Michael, De Moya, Mark, Augusto Gomes, Carlos, Bhangu, Aneel, Agresta, Ferdinando, Moore, Ernest E., Soreide, Kjetil, Griffiths, Ewen, De Castro, Steve, Kashuk, Jeffry, Kluger, Yoram, Leppaniemi, Ari, Ansaloni, Luca, Andersson, Manne, Coccolini, Federico, Coimbra, Raul, Gurusamy, Kurinchi S., Cesare Campanile, Fabio, Biffl, Walter, Chiara, Osvaldo, Moore, Fred, Peitzman, Andrew B., Fraga, Gustavo P., Costa, David, Maier, Ronald V., Rizoli, Sandro, Balogh, Zsolt J., Bendinelli, Cino, Cirocchi, Roberto, Tonini, Valeria, Piccinini, Alice, Tugnoli, Gregorio, Jovine, Elio, Persiani, Roberto, Biondi, Antonio, Scalea, Thomas, Stahel, Philip, Ivatury, Rao, Velmahos, George, Andersson, Roland, Di Saverio, Salomone, Birindelli, Arianna, Kelly, Micheal D., Catena, Fausto, Weber, Dieter G., Sartelli, Massimo, Sugrue, Michael, De Moya, Mark, Augusto Gomes, Carlos, Bhangu, Aneel, Agresta, Ferdinando, Moore, Ernest E., Soreide, Kjetil, Griffiths, Ewen, De Castro, Steve, Kashuk, Jeffry, Kluger, Yoram, Leppaniemi, Ari, Ansaloni, Luca, Andersson, Manne, Coccolini, Federico, Coimbra, Raul, Gurusamy, Kurinchi S., Cesare Campanile, Fabio, Biffl, Walter, Chiara, Osvaldo, Moore, Fred, Peitzman, Andrew B., Fraga, Gustavo P., Costa, David, Maier, Ronald V., Rizoli, Sandro, Balogh, Zsolt J., Bendinelli, Cino, Cirocchi, Roberto, Tonini, Valeria, Piccinini, Alice, Tugnoli, Gregorio, Jovine, Elio, Persiani, Roberto, Biondi, Antonio, Scalea, Thomas, Stahel, Philip, Ivatury, Rao, Velmahos, George, and Andersson, Roland

Abstract

Acute appendicitis (AA) is among the most common cause of acute abdominal pain. Diagnosis of AA is challenging; a variable combination of clinical signs and symptoms has been used together with laboratory findings in several scoring systems proposed for suggesting the probability of AA and the possible subsequent management pathway. The role of imaging in the diagnosis of AA is still debated, with variable use of US, CT and MRI in different settings worldwide. Up to date, comprehensive clinical guidelines for diagnosis and management of AA have never been issued. In July 2015, during the 3rd World Congress of the WSES, held in Jerusalem (Israel), a panel of experts including an Organizational Committee and Scientific Committee and Scientific Secretariat, participated to a Consensus Conference where eight panelists presented a number of statements developed for each of the eight main questions about diagnosis and management of AA. The statements were then voted, eventually modified and finally approved by the participants to The Consensus Conference and lately by the board of co-authors. The current paper is reporting the definitive Guidelines Statements on each of the following topics: 1) Diagnostic efficiency of clinical scoring systems, 2) Role of Imaging, 3) Non-operative treatment for uncomplicated appendicitis, 4) Timing of appendectomy and in-hospital delay, 5) Surgical treatment 6) Scoring systems for intra-operative grading of appendicitis and their clinical usefulness 7) Non-surgical treatment for complicated appendicitis: abscess or phlegmon 8) Pre-operative and post-operative antibiotics.

Published
2016
Full Text
View/download PDF

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