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1. Grade III blunt splenic injury without contrast extravasation - World Society of Emergency Surgery Nijmegen consensus practice

Author

Amico, F., Anning, R., Bendinelli, C., Balogh, Z. J., Leppaniemi, A., Aparicio-Sanchez, D., Hermans, E., Coccolini, F., Abu-Zidan, F. M., Chiarugi, M., Arvieux, C., Pirozzolo, G., Khokha, V., Tolonen, M., Edward, T., Sugrue, M., Ceresoli, M., Muhrbeck, M., Mohan, R., Piscioneri, F., Ietto, G., Chiara, O., Catena, F., Amico, F, Anning, R, Bendinelli, C, Balogh, Z, Leppaniemi, A, Aparicio-Sanchez, D, Hermans, E, Coccolini, F, Abu-Zidan, F, Chiarugi, M, Arvieux, C, Pirozzolo, G, Khokha, V, Tolonen, M, Edward, T, Sugrue, M, Ceresoli, M, Muhrbeck, M, Mohan, R, Piscioneri, F, Ietto, G, Chiara, O, Catena, F, and HUS Abdominal Center

Subjects
Delphi Technique, IMPACT, Modified delphi, Contrast Media, Computed tomography, Injury, Wounds, Nonpenetrating, Injury Severity Score, 0302 clinical medicine, Surveys and Questionnaires, Acute care, Recent trauma, Contrast extravasation, 030212 general & internal medicine, Practice variation, medicine.diagnostic_test, lcsh:Medical emergencies. Critical care. Intensive care. First aid, Blunt, Consensus, Grade III, Questionnaire, Spleen, Trauma, WSES, 3. Good health, Emergency Medicine, Research Article, medicine.medical_specialty, lcsh:Surgery, Consensu, 03 medical and health sciences, Emergency surgery, medicine, Humans, NONOPERATIVE MANAGEMENT, business.industry, 030208 emergency & critical care medicine, lcsh:RD1-811, lcsh:RC86-88.9, ADULTS, 3126 Surgery, anesthesiology, intensive care, radiology, medicine.disease, Bleeding diathesis, Reconstructive and regenerative medicine Radboud Institute for Health Sciences [Radboudumc 10], IV, Emergency medicine, Surgery, Tomography, X-Ray Computed, business
Abstract

Background Recent trauma guidelines recommend non-operative management for grade III splenic injury without contrast extravasation on computed tomography. Nevertheless, such recommendations rely on low-quality evidence, and practice variation characterizes clinical management for this type of injury. We aimed to identify the role of eleven selected clinical factors influencing the management of grade III splenic injury without contrast extravasation by expert consensus and a modified Delphi approach. Methods A questionnaire was developed with the endorsement of the World Society of Emergency Surgery (WSES). This was delivered and answered live by acute care surgeons attending the 6th WSES congress in Nijmegen in 2019. A dedicated mobile phone application was utilized to collect the answers. All answers were evaluated for areas of discrepancy with an 80% threshold for consensus between respondents. Results Three factors generated discrepancy in opinion for managing this pattern of injury: the patients’ injury severity, the presence of a bleeding diathesis, and an associated intra-abdominal injury. Agreement was obtained for the other eight factors. Conclusion Researchers should focus their efforts on the identified area of discrepancy. Clinicians should use additional care in the presence of the three factors for which discordant opinions were found.

Published
2020

2. Ethical considerations in conducting surgical research in severe complicated intra-abdominal sepsis

Author

Doig, C. J., Page, S. A., Mckee, J. L., Moore, E. E., Abu-Zidan, F. M., Carroll, R., Marshall, J. C., Faris, P. D., Tolonen, M., Catena, F., Cocolini, F., Sartelli, M., Ansaloni, L., Minor, S. F., Peirera, B. M., Diaz, J. J., Kirkpatrick, A. W., Roberts, D. J., Leppaniemi, A., Jenne, C. N., Odobez, Chiara, Kubes, P., Manns, B., Kluger, Y., Fraga, G. P., Pereira, B. M., Sugrue, M., Holm, T., Ren, J., Ball, C. G., Coimbra, R., Balogh, Z. J., Dixon, E., Biffl, W., Maclean, A., Ball, I., Drover, J. W., Mcbeth, P. B., Posadas-Calleja, J. G., Parry, N. G., Di Saverio, S., Ordonez, C. A., Bendinelli, C., Macdonald, B., Dunham, M., Reso, A., Vogt, K. N., Blaser, A. R., Malbrain, M., Tartaglia, D., De Waele, J., Dubuisson, V., Lampela, H., Bodnar, Z., Isik, A., Picetti, E., Hameed, M., Garraway, N. R., Julien, L., Widder, S., Bradley, N. L., Engels, P. T., Leeper, W. R., Beckett, A., Supporting clinical sciences, and Intensive Care

Subjects
medicine.medical_specialty, Open-abdomen, lcsh:Surgery, Intra-peritoneal sepsis, multiple organ dysfunction, Review, 030230 surgery, 03 medical and health sciences, 0302 clinical medicine, Sepsis, Humans, Medicine, Prospective Studies, Digestive System Surgical Procedures, Medicine(all), Surgical research, Informed Consent, business.industry, lcsh:Medical emergencies. Critical care. Intensive care. First aid, Correction, lcsh:RD1-811, lcsh:RC86-88.9, WAIVER, 3. Good health, Intra abdominal sepsis, Surgery, Research Design, Randomized Controlled Trial, Emergency Medicine, Consent, Multiple organ dysfunction, Randomized controlled trial, Waiver, consent, business
Abstract

Background Severe complicated intra-abdominal sepsis (SCIAS) has high mortality, thought due in part to progressive bio-mediator generation, systemic inflammation, and multiple organ failure. Treatment includes early antibiotics and operative source control. At surgery, open abdomen management with negative-peritoneal-pressure therapy (NPPT) has been hypothesized to mitigate MOF and death, although clinical equipoise for this operative approach exists. The Closed or Open after Laparotomy (COOL) study (https://clinicaltrials.gov/ct2/show/NCT03163095) will prospectively randomize eligible patients intra-operatively to formal abdominal closure or OA with NPTT. We review the ethical basis for conducting research in SCIAS. Main body Research in critically ill incapacitated patients is important to advance care. Conducting research among SCIAS is complicated due to the severity of illness including delirium, need for emergent interventions, diagnostic criteria confirmed only at laparotomy, and obtundation from anaesthesia. In other circumstances involving critically ill patients, clinical experts have worked closely with ethicists to apply principles that balance the rights of patients whilst simultaneously permitting inclusion in research. In Canada, the Tri-Council Policy Statement-2 (TCPS-2) describes six criteria that permit study enrollment and randomization in such situations: (a) serious threat to the prospective participant requires immediate intervention; (b) either no standard efficacious care exists or the research offers realistic possibility of direct benefit; (c) risks are not greater than that involved in standard care or are clearly justified by prospect for direct benefits; (d) prospective participant is unconscious or lacks capacity to understand the complexities of the research; (e) third-party authorization cannot be secured in sufficient time; and (f) no relevant prior directives are known to exist that preclude participation. TCPS-2 criteria are in principle not dissimilar to other (inter)national criteria. The COOL study will use waiver of consent to initiate enrollment and randomization, followed by surrogate or proxy consent, and finally delayed informed consent in subjects that survive and regain capacity. Conclusions A delayed consent mechanism is a practical and ethical solution to challenges in research in SCIAS. The ultimate goal of consent is to balance respect for patient participants and to permit participation in new trials with a reasonable opportunity for improved outcome and minimal risk of harm.

Published
2019
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3. A pandemic recap: lessons we have learned

Author

Ugo Boggi, Julival Ribeiro, Luigi Bonavina, Mauro Pistello, Fikri M. Abu-Zidan, Massimo Sartelli, Dieter G. Weber, Vladimir Khokha, Pietro Brambillasca, Dario Tartaglia, Yoram Kluger, Lorenzo Cobianchi, Damien Massalou, Cristian Mesina, Arda Isik, Alessandro Cucchetti, Mutasim M. Elmangory, Xavier Guirao, Salomone Di Saverio, Ibrahima Sall, Emmanouil Pikoulis, Aleksei V. Osipov, Krstina Doklestic, Mahir Gachabayov, Maria Grazia Sibilla, Charalampos Seretis, Fabio Tumietto, M Chirica, Paola Fugazzola, Isidoro Di Carlo, Gian Luca Baiocchi, Chad G. Ball, Yunfeng Cui, Lorenzo Ghiadoni, Timothy Craig Hardcastle, Massimo Fantoni, Boun Kim Tan, Bruno Turri, Edoardo Picetti, Federico Coccolini, Jacek Czepiel, Jae Il Kim, Evgeni Dimitrov, R. V. Maier, Camilla Cremonini, Ali I. Yahya, I. A. Kryvoruchko, Akira Kuriyama, Wagih Ghannam, Shamshul Ansari, Fernando Machado, Enrico Cicuttin, Sumita A Jain, Ronald Kiguba, Doron Kopelman, Martha Quiodettis, Michele Pisano, Marco Ceresoli, Harry van Goor, Garima Kapoor, Andrew W. Kirkpatrick, Mauro Podda, Angelo Gemignani, Boris Sakakushev, Souha S. Kanj, Ernest E. Moore, Samir Delibegovic, Cinzia Monti, Massimo Girardis, Matti Tolonen, Mushira Enani, Massimo Chiarugi, Carlos A. Ordoñez, Zaza Demetrashvili, Leonardo Pagani, Ziad A. Memish, Pradeep H. Navsaria, Paolo Malacarne, Nicola de’Angelis, Giandomenico Luigi Biancofiore, Fulvio Basolo, Goran Augustin, Junichi Matsumoto, Fausto Catena, Ari Leppäniemi, Gabriel Rodrigues, W.P. Zuidema, Raul Coimbra, Manu Malbrain, Emilio Maseda, Suman Baral, Demetrios Demetriades, M. Hecker, Davide Corbella, András Vereczkei, Sanjay Marwah, Francesco Forfori, Donal B. O’Connor, Carlo Palombo, Vishal G Shelat, Michelangelo Scaglione, Walter L. Biffl, Andrey Litvin, Majdi N. Al-Hasan, Sameer Dhingra, Miklosh Bala, Oussama Baraket, Carlos Augusto Gomez, Offir Ben-Ishay, Gabriele Materazzi, Paolo Carcoforo, Rita Galeiras, Belinda De Simone, Ionut Negoi, Mirco Nacoti, Luca Ansaloni, Bruno Viaggi, Jose J. Diaz, Alessandro Puzziello, Bruno Amato, Lostoridis Eftychios, Cino Bendinelli, Mario Testini, Andreas Hecker, Martin Reichert, Francesco Corradi, Korey Das, Gustavo M. Machain Vega, Evika Karamagioli, Rao R. Ivatury, HUS Abdominal Center, II kirurgian klinikka, Coccolini, F, Cicuttin, E, Cremonini, C, Tartaglia, D, Viaggi, B, Kuriyama, A, Picetti, E, Ball, C, Abu-Zidan, F, Ceresoli, M, Turri, B, Jain, S, Palombo, C, Guirao, X, Rodrigues, G, Gachabayov, M, Machado, F, Eftychios, L, Kanj, S, Di Carlo, I, Di Saverio, S, Khokha, V, Kirkpatrick, A, Massalou, D, Forfori, F, Corradi, F, Delibegovic, S, Machain Vega, G, Fantoni, M, Demetriades, D, Kapoor, G, Kluger, Y, Ansari, S, Maier, R, Leppaniemi, A, Hardcastle, T, Vereczkei, A, Karamagioli, E, Pikoulis, E, Pistello, M, Sakakushev, B, Navsaria, P, Galeiras, R, Yahya, A, Osipov, A, Dimitrov, E, Doklestic, K, Pisano, M, Malacarne, P, Carcoforo, P, Sibilla, M, Kryvoruchko, I, Bonavina, L, Kim, J, Shelat, V, Czepiel, J, Maseda, E, Marwah, S, Chirica, M, Biancofiore, G, Podda, M, Cobianchi, L, Ansaloni, L, Fugazzola, P, Seretis, C, Gomez, C, Tumietto, F, Malbrain, M, Reichert, M, Augustin, G, Amato, B, Puzziello, A, Hecker, A, Gemignani, A, Isik, A, Cucchetti, A, Nacoti, M, Kopelman, D, Mesina, C, Ghannam, W, Ben-Ishay, O, Dhingra, S, Coimbra, R, Moore, E, Cui, Y, Quiodettis, M, Bala, M, Testini, M, Diaz, J, Girardis, M, Biffl, W, Hecker, M, Sall, I, Boggi, U, Materazzi, G, Ghiadoni, L, Matsumoto, J, Zuidema, W, Ivatury, R, Enani, M, Litvin, A, Al-Hasan, M, Demetrashvili, Z, Baraket, O, Ordonez, C, Negoi, I, Kiguba, R, Memish, Z, Elmangory, M, Tolonen, M, Das, K, Ribeiro, J, O'Connor, D, Tan, B, Van Goor, H, Baral, S, De Simone, B, Corbella, D, Brambillasca, P, Scaglione, M, Basolo, F, De'Angelis, N, Bendinelli, C, Weber, D, Pagani, L, Monti, C, Baiocchi, G, Chiarugi, M, Catena, F, Sartelli, M, Surgery, Other Research, APH - Quality of Care, Department of Surgery, and Faculty of Health Sciences

Subjects
Biomedical Research, Pandemics / prevention & control, Delivery of Health Care / organization & administration, International Cooperation, Reflection, 030230 surgery, Global Health, Health Services Accessibility, COVID-19 / epidemiology, 0302 clinical medicine, White paper, Telemedicine / organization & administration, Multidisciplinary approach, Pandemic, Health care, Global health, 030212 general & internal medicine, Letter to the Editor, Health Policy, Politics, Medical emergencies. Critical care. Intensive care. First aid, COVID-19 / therapy, Public relations, Telemedicine, Primary Health Care / organization & administration, 3. Good health, Policy, International, Emergency Medicine, Thought, medicine.medical_specialty, COVID-19 Vaccines, RD1-811, Thoughts, Mass Vaccination, Mass Vaccination / organization & administration, NO, 03 medical and health sciences, medicine, Politic, Humans, Ethic, Healthcare Disparities, Biology, Pandemics, Health policy, LS7_4, Ethics, Pandemia, Primary Health Care, RC86-88.9, business.industry, Public health, COVID-19, Health Status Disparities, 3126 Surgery, anesthesiology, intensive care, radiology, Delivery of Health Care, Reconstructive and regenerative medicine Radboud Institute for Health Sciences [Radboudumc 10], Surgery, business, COVID-19 / diagnosis
Abstract

Contains fulltext : 238976.pdf (Publisher’s version ) (Open Access) On January 2020, the WHO Director General declared that the outbreak constitutes a Public Health Emergency of International Concern. The world has faced a worldwide spread crisis and is still dealing with it. The present paper represents a white paper concerning the tough lessons we have learned from the COVID-19 pandemic. Thus, an international and heterogenous multidisciplinary panel of very differentiated people would like to share global experiences and lessons with all interested and especially those responsible for future healthcare decision making. With the present paper, international and heterogenous multidisciplinary panel of very differentiated people would like to share global experiences and lessons with all interested and especially those responsible for future healthcare decision making.

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

Author

Fabio Cesare Campanile, Rifat Latifi, Harry van Goor, Francesco Pata, Michael D. Kelly, Mauro Podda, Zaza Demetrashvili, Massimo Sartelli, R. J. Davies, Dimitrios Damaskos, Zsolt J. Balogh, Antonio Tarasconi, Gustavo Pereira Fraga, Fausto Catena, Fakri Abu-Zidan, Sandro Rizoli, Adolfo Pisanu, Ernest E. Moore, Boris Sakakushev, Richard P. G. ten Broek, Osvaldo Chiara, Matti Tolonen, Gian Luigi De' Angelis, Andrey Litvin, Dieter G. Weber, Kjetil Søreide, Andrew W. Kirkpatrick, Rao R. Ivatury, Raul Coimbra, Cino Bendinelli, Michael Sugrue, Oreste Romeo, Luca Ansaloni, Marja A. Boermeester, Goran Augustin, Gabriele Sganga, Ari Leppäniemi, Marco Ceresoli, Ronald V. Maier, Alice Gori, Walter L. Biffl, George C. Velmahos, Arianna Birindelli, Carlos Augusto Gomes, Massimo Chiarugi, Jeffry L. Kashuk, Nicola De Angelis, David W da Costa, Federico Coccolini, Andrew B. Peitzman, Helmut Segovia-Lohse, Salomone Di Saverio, Yoram Kluger, Belinda De Simone, Thomas M. Scalea, Edward C.T.H. Tan, Isidoro Di Carlo, Roland Andersson, Gian Luca Baiocchi, G. Tomadze, Apollo - University of Cambridge Repository, Di Saverio, S, Podda, M, De Simone, B, Ceresoli, M, Augustin, G, Gori, A, Boermeester, M, Sartelli, M, Coccolini, F, Tarasconi, A, De' Angelis, N, Weber, D, Tolonen, M, Birindelli, A, Biffl, W, Moore, E, Kelly, M, Soreide, K, Kashuk, J, Ten Broek, R, Gomes, C, Sugrue, M, Davies, R, Damaskos, D, Leppaniemi, A, Kirkpatrick, A, Peitzman, A, Fraga, G, Maier, R, Coimbra, R, Chiarugi, M, Sganga, G, Pisanu, A, De' Angelis, G, Tan, E, Van Goor, H, Pata, F, Di Carlo, I, Chiara, O, Litvin, A, Campanile, F, Sakakushev, B, Tomadze, G, Demetrashvili, Z, Latifi, R, Abu-Zidan, F, Romeo, O, Segovia-Lohse, H, Baiocchi, G, Costa, D, Rizoli, S, Balogh, Z, Bendinelli, C, Scalea, T, Ivatury, R, Velmahos, G, Andersson, R, Kluger, Y, Ansaloni, L, Catena, F, HUS Abdominal Center, II kirurgian klinikka, University of Helsinki, and Helsinki University Hospital Area

Subjects
UNCOMPLICATED ACUTE APPENDICITIS, CT scan appendicitis, Appendicitis / surgery, Settore MED/18 - CHIRURGIA GENERALE, Non-operative management, Delphi method, Review, 030230 surgery, Imaging, SUCCESSFUL NONOPERATIVE TREATMENT, 0302 clinical medicine, Antibiotics, Laparoscopy / methods, Appendicitis guideline, Grading (education), Laparoscopy, Appendicitis diagnosis score, Appendiceal absce, Evidence-Based Medicine, medicine.diagnostic_test, Consensus conference, lcsh:Medical emergencies. Critical care. Intensive care. First aid, C-REACTIVE PROTEIN, 3. Good health, Anti-Bacterial Agents, Acute appendicitis, Appendicitis guidelines, Jerusalem guidelines, Alvarado score, Adult Appendicitis Score, Complicated appendicitis, Appendectomy, Laparoscopic appendectomy, Diagnostic laparoscopy, Phlegmon, Appendiceal abscess, 030220 oncology & carcinogenesis, Abdominal Pain / surgery, Acute Disease, Practice Guidelines as Topic, MEASURING ANATOMIC SEVERITY, Emergency Medicine, CT scan appendiciti, medicine.medical_specialty, Jerusalem guideline, lcsh:Surgery, [object Object], Complicated appendiciti, ANTIBIOTIC-THERAPY, COMPLICATED ACUTE APPENDICITIS, 03 medical and health sciences, medicine, SURGICAL SITE INFECTION, Humans, Abdominal Pain / diagnosis, Anti-Bacterial Agents / therapeutic use, 3-PORT LAPAROSCOPIC APPENDECTOMY, business.industry, General surgery, Kirurgi, Antibiotic, Evidence-based medicine, lcsh:RD1-811, lcsh:RC86-88.9, 3126 Surgery, anesthesiology, intensive care, radiology, medicine.disease, Appendicitis, INFLAMMATORY RESPONSE SCORE, Abdominal Pain, Reconstructive and regenerative medicine Radboud Institute for Health Sciences [Radboudumc 10], Appendicitis / diagnosis, CLINICAL-PREDICTION RULES, Surgery, Acute appendiciti, business
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-hospital delay, (4) surgical treatment, (5) intra-operative grading of AA, (6) ,management of perforated AA with phlegmon or abscess, and (7) peri-operative antibiotic therapy.

Published
2020
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5. Complicated intra-abdominal infections worldwide : the definitive data of the CIAOW Study

Author

Sartelli, Massimo, Catena, Fausto, Ansaloni, Luca, Coccolini, Frederico, Corbella, Davide, Moore, Ernest, Malangoni, Mark, Velmahos, George, Coimbra, Raul, Koike, Kaoru, Leppaniemi, Ari, Biffl, Walter, Balogh, Zsolt, Bendinelli, Cino, Gupta, Sanjay, Kluger, Yoram, Agresta, Ferdinando, Di Saverio, Salmone, Tugnoli, Gregorio, Jovine, Elio, Ordonez, Carlos, Whelan, James, Fraga, Gustavo, Carlos, Gomes, Augusto, Pereira, Gerson, Yuan, Kuo-Ching, Bala, Miklosh, Peev, Miroslav, Ben-Ishay, Offir, Cui, Yunfeng, Marwah, Sanjay, Zachariah, Sanoop, Wani Imtiaz, Rangarajan, Muthukumaran, Sakakushev, Boris, Kong, Victor, Ahmed, Adamu, Abbas, Ashraf, Gonsaga, Ricardo, Guercioni, Gianluca, Vettoretto, Nereo, Poiasina, Elia, Díaz-Nieto, Rafael, Massalou, Damien, Skrovina, Matej, Gerych, Ihor, Augustin, Goran, Kenig, Jakub, Khokha, Vladimir, Tranà, Cristian, Kok, Kenneth, Mefire, Alain, Lee, Jae, Hong, Suk-Kyung, Lohse, Helmut, Ghnnam, Wagih, Verni, Alfredo, Lohsiriwat, Varut, Siribumrungwong, Boonying, El Zalabany, Tamer, Tavares, Alberto, Baiocchi, Gianluca, Das, Koray, Jarry, Julien, Zida, Maurice, Sato, Norio, Murata, Kiyoshi, Shoko, Tomohisa, Irahara, Takayuki, Hamedelneel, Ahmed, Naidoo, Noel, Adesunkanmi, Abdul, Kobe, Yoshiro, Ishii, Wataru, Oka, Kazuyuki, Izawa, Yoshimitsu, Hamid, Hytham, Khan, Iqbal, Attri, AK, Sharma, Rajeev, Sanjuan, Juan, Badiel, Marisol, Barnabé, Rita, II kirurgian klinikka, [Sartelli, M] Department of Surgery, Macerata Hospital, Macerata, Italy. [Catena, F] Emergency Surgery, Maggiore Parma Hospital, Parma, Italy. [Ansaloni, L, Coccolini, F, Poiasina, E] Department of General Surgery, Ospedali Riuniti, Bergamo, Italy. [Corbella, D] Department of Anestesiology, Ospedali Riuniti, Bergamo, Italy. [Moore, EE, Biffl, W] Department of Surgery, Denver Health Medical Center, Denver, USA. [Malangoni, M] American Board of Surgery, Philadelphia, USA. [Velmahos, G, Peev, MP] Division of Trauma, Emergency Surgery and Surgical Critical Care, Harvard Medical School, Massachusetts General Hospital, Massachusetts, USA. [Coimbra, R] Department of Surgery, UC San Diego Health System, San Diego, USA. [Koike, K] Department of Primary Care & Emergency Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan. [Leppaniemi, A] Department of Abdominal Surgery, University Hospital Meilahti, Helsinki, Finland. [Balogh, Z, Bendinelli, C] Department of Surgery, University of Newcastle, Newcastle, NSW, Australia. [Gupta, S] Department of Surgery, Govt Medical College and Hospital, Chandigarh, India. [Kluger, Y, Ben-Ishay, O, Attri, A, Sharma, R] Department of General Surgery, Rambam Health Care Campus, Haifa, Israel. [Agresta, F] Department of Surgery, Adria Hospital Adria, Adria, Italy. [Di Saverio, S, Tugnoli, G] Trauma Surgery Unit, Maggiore Hospital, Bologna, Italy. [Jovine, E, Bananbé, R] Department of Surgery, Maggiore Hospital, Bologna, Italy. [Ordoñez, CA, Sanjuán, J, Badiel, M] Department of Surgery, Fundación Valle del Lilí, Cali, Colombia. [Whelan, JF] Division of Trauma/Critical Care Department of Surgery Virginia Commonwealth University, Richmond, VA, USA. [Fraga, GP] Division of Trauma Surgery, Campinas University, Campinas, Brazil. [Gomes, CA] Department of Surgery, Monte Sinai Hospital, Juiz de Fora, Brazil. [Pereira, CA] Department of Surgery, Emergency Unit, Ribeirão Preto, Brazil. [Yuan, KC]Department of Surgery, Chang Gung Memorial Hospital, Taoyuan, Taiwan. [Bala, M] Department of General Surgery, Hadassah Medical Center, Jerusalem, Israel. [Cui, Y] Department of Surgery, Tianjin Nankai Hospital, Nankai Clinical School of Medicine, Tianjin Medical University, Tianjin, China. [Marwah, S] Department of Surgery, Pt BDS Post-graduate Institute of Medical Sciences, Rohtak, India. [Zachariah, S] Department of Surgery, MOSC Medical College, Cochin, India. [Wani, I] Department of Surgery, SKIMS, Srinagar, India. [Rangarajan, M] Department of Surgery, Kovai Medical Center, Coimbatore, India. [Shakakusev, B] First Clinic of General Surgery, University Hospital/UMBAL/St George Plovdiv, Plovdiv, Bulgaria. [Kong, V] Department of Surgery, Edendale Surgery, Pietermaritzburg, Republic of South Africa. [Ahmed, A] Department of Surgery, Ahmadu Bello University Teaching Hospital Zaria, Kaduna, Nigeria. [Abbas, A, Ghnnam, W] Department of Surgery, Mansoura University Hospital, Mansoura, Egypt. [Gonsaga, RA] Department of Surgery, Faculdades Integradas Padre Albino, Catanduva, Brazil. [Guercioni, G] Department of Surgery, Mazzoni Hospital, Ascoli Piceno, Italy. [Vettoretto, N] Department of Surgery, Mellini Hospital, Chiari, BS, Italy. [Díaz-Nieto, R] Department of General and Digestive Surgery, Virgen de la Victoria, University Hospital, Málaga, Spain. [Massalou, D] Department of General Surgery and Surgical Oncology, Université de Nice Sophia-Antipolis, Universitary Hospital of Nice, Nice, France. [Skrovina, M] Department of Surgery, Hospital and Oncological Centre, Novy Jicin, Czech Republic. [Gerych, I] Department of General Surgery, Lviv Emergency Hospital, Lviv, Ukraine. [Augustin, G] Department of Surgery, University Hospital Center Zagreb, Zagreb, Croatia. [Kenig, J] 3rd Department of General Surger Jagiellonian Univeristy, Narutowicz Hospital, Krakow, Poland. [Khokha, V] Department of Surgery, Mozyr City Hospital, Mozyr, Belarus. [Tranà, C] Department of Surgery, Ancona University, Ancona, Italy. [Kok, KY] Department of Surgery, Ripas Hospital, Bandar Seri Begawan, Brunei. [Mefire, AC] Clinical Sciences, Regional Hospitals Limbe and Buea, Limbe, Cameroon. [Lee, JG] Department of Surgery, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea. [Hong, SK] Division of Trauma and Surgical Critical Care, Department of Surgery, University of Ulsan, Seoul, Republic of Korea. [Lohse, HA] II Cátedra de Clínica Quirúrgica, Hospital de Clínicas, Asuncion, Paraguay. [Verni, A] Department of Surgery, Cutral Có Clinic, Cutral Có, Argentina. [Lohsiriwat, V] Department of Surgery, Faculty of Medicine Siriraj Hospital, Bangkok, Thailand. [Siribumrungwong, B] Department of Surgery, Thammasat University Hospital, Pathumthani, Thailand. [El Zalabany, T] Department of Surgery, Bahrain Defence Force Hospital, Manama, Bahrain. [Tavares, A] Department of Surgery, Hospital Regional de Alta Especialidad del Bajio, Leon, Mexico. [Baiocchi, G] Clinical and Experimental Sciences, Brescia Ospedali Civili, Brescia, Italy. [Das, K] General Surgery, Adana Numune Training and Research Hospital, Adana, Turkey. [Jarry, J] Visceral Surgery, Military Hospital Desgenettes, Lyon, France. [Zida, M] Visceral Surgery, Teaching Hospital Yalgado Ouedraogo, Ouedraogo, Burkina Faso. [Murata, K] Department of Acute and Critical care medicine, Tokyo Medical and Dental University, Tokyo, Japan. [Shoko, T] he Shock Trauma and Emergency Medical Center, Matsudo City Hospital, Chiba, Japan. [Irahara, T] Emergency and Critical Care Center of Nippon Medical School, Tama-Nagayama Hospital, Tokyo, Japan. [Hamedelneel, AO] Department of Surgery, Our Lady of Lourdes Hospital, Drogheda, Ireland. [Naidoo, N] Department of Surgery, Port Shepstone Hospital, Port Shepstone, South Africa. [Adesunkanmi, AR] Department of Surgery, Obafemi Awolowo UNiversity Hospital, Ile-Ife, Nigeria. [Kobe, Y] Department of Emergency and Critical Care Medicine, Chiba University Hospital, Chiba, Japan. [Ishii, W] Department of Emergency and Critical Care Medicine, Chiba University Hospital, Chiba, Japan, and Depatment of Emergency Medicine, Kyoto Second Red Cross Hospital, Kyoto, Japan. [Oka, K] Tajima emergency & Critical Care Medical Center, Toyooka Public Hospital, Toyooka, Hyogo, Japan. [Izawa, Y] Emergency and Critical Care Medicine, Jichi Medical University, Shimotsuke, Japan. [Hamid, H] Department of Surgery, Mayo General Hospital Castlebar Co. Mayo, Castlebar, Ireland.

Subjects
Analytical, Diagnostic and Therapeutic Techniques and Equipment::Surgical Procedures, Operative::Digestive System Surgical Procedures [Medical Subject Headings], APPENDICEAL ABSCESS, medicine.medical_treatment, Diseases::Bacterial Infections and Mycoses::Infection::Cross Infection [Medical Subject Headings], Phenomena and Processes::Microbiological Phenomena::Drug Resistance, Microbial [Medical Subject Headings], Analytical, Diagnostic and Therapeutic Techniques and Equipment::Therapeutics::Drainage [Medical Subject Headings], Organisms::Eukaryota::Animals::Chordata::Vertebrates::Mammals::Primates::Haplorhini::Catarrhini::Hominidae::Humans [Medical Subject Headings], Analytical, Diagnostic and Therapeutic Techniques and Equipment::Surgical Procedures, Operative::Reoperation [Medical Subject Headings], Study Protocol, Infección hospitalaria, Procedimientos quirúrgicos del sistema digestivo, Diseases::Bacterial Infections and Mycoses::Infection::Sepsis [Medical Subject Headings], Publication Characteristics::Study Characteristics::Multicenter Study [Medical Subject Headings], Enfermedad crítica, Adulto, Mortality rate, Farmacoresistencia microbiana, Immunosuppression, Diverticulitis, Humanos, 3. Good health, Emergency Medicine, Diseases::Digestive System Diseases::Peritoneal Diseases::Peritonitis [Medical Subject Headings], KLEBSIELLA-PNEUMONIAE, Reoperación, Diseases::Pathological Conditions, Signs and Symptoms::Pathologic Processes::Disease Attributes::Critical Illness [Medical Subject Headings], medicine.medical_specialty, CHOLECYSTECTOMY, education, Peritonitis, RELAPAROTOMY, Diseases::Bacterial Infections and Mycoses::Infection::Suppuration::Abscess::Abdominal Abscess [Medical Subject Headings], SECONDARY PERITONITIS, Internal medicine, complicated intra-abdomina infections, appendicitis, cholecystitis, postoperative, colonic perforation, gastroduodenal perforation, diverticulitis, small bowel perforation, Named Groups::Persons::Age Groups::Adult [Medical Subject Headings], medicine, MANAGEMENT, METAANALYSIS, Estudio multicéntrico, Diseases::Bacterial Infections and Mycoses::Infection::Intraabdominal Infections [Medical Subject Headings], SEPSIS, business.industry, Abdominal Infection, Absceso abdominal, ACUTE CHOLECYSTITIS, medicine.disease, 3126 Surgery, anesthesiology, intensive care, radiology, Infecciones intraabdominales, Appendicitis, Surgery, Cholecystitis, Drenaje, Cholecystectomy, business, DIVERTICULITIS
Abstract

Journal Article; The CIAOW study (Complicated intra-abdominal infections worldwide observational study) is a multicenter observational study underwent in 68 medical institutions worldwide during a six-month study period (October 2012-March 2013). The study included patients older than 18 years undergoing surgery or interventional drainage to address complicated intra-abdominal infections (IAIs). 1898 patients with a mean age of 51.6 years (range 18-99) were enrolled in the study. 777 patients (41%) were women and 1,121 (59%) were men. Among these patients, 1,645 (86.7%) were affected by community-acquired IAIs while the remaining 253 (13.3%) suffered from healthcare-associated infections. Intraperitoneal specimens were collected from 1,190 (62.7%) of the enrolled patients. 827 patients (43.6%) were affected by generalized peritonitis while 1071 (56.4%) suffered from localized peritonitis or abscesses. The overall mortality rate was 10.5% (199/1898). According to stepwise multivariate analysis (PR = 0.005 and PE = 0.001), several criteria were found to be independent variables predictive of mortality, including patient age (OR = 1.1; 95%CI = 1.0-1.1; p

Published
2014

6. Complicated intra-abdominal infections in a worldwide context: an observational prospective study (CIAOW Study)

Author

Ashraf Abbas, Cristian Tranà, Offir Ben-Ishay, Sanjay Gupta, Kenneth Y.Y. Kok, Kuo Ching Yuan, Khalid Al Khalifa, Kaoru Koike, Alberto Tavares, Tomohisa Shoko, Zsolt J. Balogh, Maurice Zida, Gian Luca Baiocchi, Alain Chichom Mefire, Sanoop K. Zachariah, Rafael Díaz-Nieto, Mark A. Malangoni, Rita Barnabé, Walter L. Biffl, Abdul Rashid K. Adesunkanmi, Ari Leppäniemi, Goran Augustin, Luca Ansaloni, Boris Sakakushev, Noel Naidoo, Federico Coccolini, Wataru Ishii, Rajeev Sharma, Nereo Vettoretto, Miroslav P. Peev, Carlos A. Ordoñez, Miklosh Bala, Suk-Kyung Hong, Ashok K. Attri, Massimo Sartelli, Ferdinando Agresta, Yoshiro Kobe, Koray Das, Norio Sato, Carlos Augusto Gomes, Ricardo Alessandro Teixeira Gonsaga, Tamer El Zalabany, Cino Bendinelli, Helmut Alfredo Segovia Lohse, Alfredo Verni, Ahmed O. Hamedelneel, Takayuki Irahara, Adamu Ahmed, Gregorio Tugnoli, Yoram Kluger, Damien Massalou, Julien Jarry, Matej Skrovina, Jae Gil Lee, Ernest E. Moore, Yunfeng Cui, Elia Poiasina, Varut Lohsiriwat, Raul Coimbra, Sanjay Marwah, Vladimir Khokha, Jakub Kenig, Wagih Ghnnam, Juan Sanjuan, Ihor Gerych, Kiyoshi Murata, Gianluca Guercioni, Victor Y. Kong, George C. Velmahos, Fausto Catena, Salomone Di Saverio, Boonying Siribumrungwong, Elio Jovine, Gerson Alves Pereira Júnior, [Sartelli,M] Department of Surgery, Macerata Hospital, Macerata, Italy. [Catena,F] Emergency Surgery, Maggiore Parma Hospital, Parma, Italy. [Ansaloni,L, Poiasina,E, Coccolini,F] Department of General Surgery, Ospedali Riuniti, Bergamo, Italy. [Moore,E, Biffl,W] Department of Surgery, Denver Health Medical Center, Denver, CO, USA. [Malangoni,M] American Board of Surgery, Philadelphia, PA, USA. [Velmahos,G, Peev,MP] Harvard Medical School, Division of Trauma, Emergency Surgery and Surgical Critical Care Massachusetts General Hospital, Boston, MA, USA. [Coimbra,R] Department of Surgery, UC San Diego Health System, San Diego, CA, USA. [Koike,K, Sato,N] Department of Primary Care & Emergency Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan. [Leppaniemi,A] Department of Abdominal Surgery, University Hospital Meilahti, Helsinki, Finland. [Balogh,Z, Bendinelli,C] Department of Surgery, University of Newcastle, Newcastle, NSW, Australia. [Gupta,S, Attri,AK, Sharma,R] Department of Surgery, Govt Medical College and Hospital, Chandigarh, India. [Kluger,Y, Ben-Ishay,O] Department of General Surgery, Rambam Health Care Campus, Haifa, Israel. [Agresta,F] Department of Surgery, Adria Hospital, Adria, Italy. [Saverio,S di, Tugnoli,G] Trauma Surgery Unit, Maggiore Hospital, Bologna, Italy. [Jovine,E, Barnabé,R] Department of Surgery, Maggiore Hospital, Bologna, Italy. [Ordonez,C, Sanjuán,J] Department of Surgery, Universidad del Valle, Fundación Valle del Lili, Cali, Colombia. [Gomes,A] Department of Surgery, Monte Sinai Hospital, Juiz de Fora, Brazil. [Pereira Junior,GA] Emergency Unit, Department of Surgery, Ribeirão Preto, Brazil . [Yuan,K-CH] Department of Surgery, Chang Gung Memorial Hospital, Taoyuan, Taiwan. [Bala,M] Department of General Surgery, Hadassah Medical Center, Jerusalem, Israel. [Cui,Y] Department of Surgery, Tianjin Nankai Hospital, Nankai Clinical School of Medicine, Tianjin Medical University, Tianjin, China. [Marwah,S] Department of Surgery, Pt BDS Post-graduate Institute of Medical Sciences, Rohtak, India. [Zachariah,S] Department of Surgery, MOSC medical college, Cochin, India. [Sakakushev,B] First Clinic of General Surgery, University Hospital /UMBAL/ St George Plovdiv, Plovdiv, Bulgaria. [Sakakushev,B] General Surgery Clinic, Medical University/University Hospital St.George, Plovdiv, Bulgaria. [Kong,V] Department of Surgery, Edendale Hospital, Pietermaritzburg, Republic of South Africa. [Ahmed,A] Department of Surgery, Ahmadu Bello University Teaching Hospital Zaria, Kaduna, Nigeria. [Abbas,A] Department of Surgery, Mansoura University Hospital, Mansoura, Egypt . [Teixeira Gonsaga,RA] Department of Surgery, Faculdades Integradas Padre Albino, Catanduva, Brazil. [Guercioni,G] Department of Surgery, Mazzoni Hospital, Ascoli Piceno, Italy. [Vettoretto,N] Department of Surgery, Mellini Hospital, Chiari (BS), Italy. [Díaz Nieto,R] Department of General and Digestive Surgery, Hospital Universitario Virgen de la Victoria, Málaga, Spain. [Massalou,D] Department of General Surgery and Surgical Oncology, Université de Nice Sophia-Antipolis, Universitary Hospital of Nice, France. [Skrovina,M] Department of Surgery, Hospital and Oncological Centre, Novy Jicin, Czech Republic. [Gerych,I] Department of General Surgery, Lviv Emergency Hospital, Lviv, Ukraine. [Agustin,G] Department of Surgery, University Hospital Center Zagreb, Zagreb, Croatia. [Kenig,J] 3rd Department of General Surger Jagiellonian Univeristy, Narutowicz Hospital, Krakow, Poland. [Khokha,V] Department of Surgery, Mozyr City Hospital, Mozyr, Belarus. [Tranà,C] Department of Surgery, Ancona University, Ancona, Italy. [Yen Kok,KY] Department of Surgery, Ripas Hospital, Bandar Seri Begawan, Brunei. [Mefire,ACH] Clinical Sciences, Regional Hospitals Limbe and Buea, Limbe, Cameroon. [Lee,JG] Department of Surgery, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea. [Hong,S-K] Division of Trauma and Surgical Critical Care, Department of Surgery, University of Ulsan, Seoul, Republic of Korea . [Segovia Lohse,HA] II Cátedra de Clínica Quirúrgica, Hospital de Clínicas, Asunción, Paraguay. [Ghnnam,W] Department of Surgery, Khamis Mushayt General Hospital, Khamis Mushayt, Saudi Arabia. [Verni,A] Department of Surgery, Cutral Co Clinic, Neuquen, Argentina. [Lohsiriwat,W] Department of Surgery, Faculty of Medicine Siriraj Hospital, Bangkok, Thailand. [Siribumrungwong,B] Department of Surgery, Thammasat University Hospital, Pathumthani, Thailand. [Tavares,A] Department of Surgery, Hospital Regional de Alta Especialidad del Bajio, León, México. [Baiocchi,G] Department of Clinical and Experimental Sciences, Brescia University, Brescia, Italy. [Das,K] General Surgery, Adana Numune Training and Research Hospital, Adana, Turkey. [Jarry,J] Visceral Surgery, Military Hospital Desgenettes, Lyon, France. [Zida,M] Visceral Surgery, Teaching Hospital Yalgado Ouedraogo, Ouagadougou, Burkina Faso. [Murata,K] Department of Acute and Critical care medicine, Tokyo Medical and Dental University, Tokyo, Japan. [Shoko,T] The Shock Trauma and Emergency Medical Center, Matsudo City Hospital, Chiba, Japan. [Irahara,T] Emergency and Critical Care Center of Nippon Medical School, Tama-Nagayama Hospital, Tokyo, Japan. [Hamedelneel,AO] Department of Surgery, Our Lady of Lourdes Hospital, Drogheda, Ireland. [Naidoo,N] Department of Surgery, Port Shepstone Hospital, Port Shepstone, South Africa. [Kayode Adesunkanmi,AR] Department of Surgery, College of Health Sciences, Obafemi Awolowo University Hospital, Ile-Ife, Nigeria. [Kobe,Y] Department of Emergency and Critical Care Medicine, Chiba University Hospital, Chiba, Japan. [El Zalabany,T, and Khalifa,K Al] Department of Surgery, Bahrain Defence Force Hospital, Manama, Bahrain. [Ishii,W] Department of Emergency Medicine, Kyoto Second Red Cross Hospital, Kyoto, Japan.

Subjects
Analytical, Diagnostic and Therapeutic Techniques and Equipment::Surgical Procedures, Operative::Drainage [Medical Subject Headings], Pediatrics, medicine.medical_specialty, Infecciones Intraabdominales, Analytical, Diagnostic and Therapeutic Techniques and Equipment::Surgical Procedures, Operative::Digestive System Surgical Procedures [Medical Subject Headings], Infección Hospitalaria, Diseases::Bacterial Infections and Mycoses::Infection::Cross Infection [Medical Subject Headings], MEDLINE, Peritonitis, Context (language use), Absceso Abdominal, Phenomena and Processes::Microbiological Phenomena::Drug Resistance, Microbial [Medical Subject Headings], Review, 030230 surgery, Enfermedad Crítica, Diseases::Bacterial Infections and Mycoses::Infection::Suppuration::Abscess::Abdominal Abscess [Medical Subject Headings], Organisms::Eukaryota::Animals::Chordata::Vertebrates::Mammals::Primates::Haplorhini::Catarrhini::Hominidae::Humans [Medical Subject Headings], Analytical, Diagnostic and Therapeutic Techniques and Equipment::Surgical Procedures, Operative::Reoperation [Medical Subject Headings], 03 medical and health sciences, 0302 clinical medicine, Named Groups::Persons::Age Groups::Adult [Medical Subject Headings], Medicine, intra-abdominal infections, Prospective cohort study, Diseases::Bacterial Infections and Mycoses::Infection::Sepsis [Medical Subject Headings], Estudio Multicéntrico, Publication Characteristics::Study Characteristics::Multicenter Study [Medical Subject Headings], Diseases::Bacterial Infections and Mycoses::Infection::Intraabdominal Infections [Medical Subject Headings], business.industry, Adulto, Mortality rate, Abdominal Infection, Mean age, Farmacoresistencia microbiana, medicine.disease, 3. Good health, Humanos, Procedimientos Quirúrgicos del Sistema Digestivo, 030220 oncology & carcinogenesis, Emergency Medicine, DOENÇAS INFECCIOSAS, Observational study, Surgery, Drenaje, Diseases::Digestive System Diseases::Peritoneal Diseases::Peritonitis [Medical Subject Headings], business, Reoperación, Diseases::Pathological Conditions, Signs and Symptoms::Pathologic Processes::Disease Attributes::Critical Illness [Medical Subject Headings]
Abstract

Despite advances in diagnosis, surgery, and antimicrobial therapy, mortality rates associated with complicated intra-abdominal infections remain exceedingly high. The World Society of Emergency Surgery (WSES) has designed the CIAOW study in order to describe the clinical, microbiological, and management-related profiles of both community- and healthcare-acquired complicated intra-abdominal infections in a worldwide context. The CIAOW study (Complicated Intra-Abdominal infection Observational Worldwide Study) is a multicenter observational study currently underway in 57 medical institutions worldwide. The study includes patients undergoing surgery or interventional drainage to address complicated intra-abdominal infections. This preliminary report includes all data from almost the first two months of the six-month study period. Patients who met inclusion criteria with either community-acquired or healthcare-associated complicated intra-abdominal infections (IAIs) were included in the study. 702 patients with a mean age of 49.2 years (range 18–98) were enrolled in the study. 272 patients (38.7%) were women and 430 (62.3%) were men. Among these patients, 615 (87.6%) were affected by community-acquired IAIs while the remaining 87 (12.4%) suffered from healthcare-associated infections. Generalized peritonitis was observed in 304 patients (43.3%), whereas localized peritonitis or abscesses was registered in 398 (57.7%) patients. The overall mortality rate was 10.1% (71/702). The final results of the CIAOW Study will be published following the conclusion of the study period in March 2013.

Published
2013
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7. 2016 WSES guidelines on acute calculous cholecystitis

Author

Sanjay Gupta, Fausto Catena, Giuseppe Borzellino, Gustavo Pereira Fraga, Dario Piazzalunga, Pierluigi Viale, Cino Bendinelli, Rifat Latifi, Philip F. Stahel, Imtiaz Wani, Kurinchi Selvan Gurusamy, M. De Moya, Yoram Kluger, G. Camapanelli, Clay Cothren Burlew, Zsolt J. Balogh, V. Koka, Ari Leppäniemi, Luigi Bonavina, Ferdinando Agresta, Federico Coccolini, Walter L. Biffl, Monica Ceresoli, Francesco Brunetti, M. D. Kelly, Boris Sakakushev, I. Bailey, Jeffry L. Kashuk, Rao R. Ivatury, Ian Civil, H. Jeekel, R. V. Maier, Gregorio Tugnoli, Luca Ansaloni, Fabio Cesare Campanile, Osvaldo Chiara, S. Uraneus, Massimo Sartelli, George C. Velmahos, A. B. Peitzmann, Michael Sugrue, Raul Coimbra, S. Di Saverio, Abe Fingerhut, Ernest E. Moore, Thomas M. Scalea, Korhan Taviloğlu, Ingo Marzi, Andrea Allegri, M. Pisano, F. A. Moore, Dieter G. Weber, Ansaloni, L, Pisano, M, Coccolini, F, Peitzmann, A, Fingerhut, A, Catena, F, Agresta, F, Allegri, A, Bailey, I, Balogh, Z, Bendinelli, C, Biffl, W, Bonavina, L, Borzellino, G, Brunetti, F, Burlew, C, Camapanelli, G, Campanile, F, Ceresoli, M, Chiara, O, Civil, I, Coimbra, R, De Moya, M, Di Saverio, S, Fraga, G, Gupta, S, Kashuk, J, Kelly, M, Koka, V, Jeekel, H, Latifi, R, Leppaniemi, A, Maier, R, Marzi, I, Moore, F, Piazzalunga, D, Sakakushev, B, Sartelli, M, Scalea, T, Stahel, P, Taviloglu, K, Tugnoli, G, Uraneus, S, Velmahos, G, Wani, I, Weber, D, Viale, P, Sugrue, M, Ivatury, R, Kluger, Y, Gurusamy, K, Moore, E, and Neurosciences

Subjects
medicine.medical_specialty, Biliary tree stone, 030230 surgery, 03 medical and health sciences, 0302 clinical medicine, Diagnosis, medicine, Cholecystectomy, ddc:610, Biliary tree stones, Abdominal infections, Acute calcolous cholecystitis, Antibiotic, Endoscopic ultrasound, Gallbladder percutaneous drainage, Magnetic resonance, Surgical risk, business.industry, General surgery, Gastroenterology, Abdominal infection, Acute calcolous cholecystiti, medicine.disease, Dermatology, 3. Good health, Cholecystitis, Emergency Medicine, 030211 gastroenterology & hepatology, Surgery, business, Diagnosi
Abstract

Acute calculus cholecystitis is a very common disease with several area of uncertainty. The World Society of Emergency Surgery developed extensive guidelines in order to cover grey areas. The diagnostic criteria, the antimicrobial therapy, the evaluation of associated common bile duct stones, the identification of “high risk” patients, the surgical timing, the type of surgery, and the alternatives to surgery are discussed. Moreover the algorithm is proposed: as soon as diagnosis is made and after the evaluation of choledocholitiasis risk, laparoscopic cholecystectomy should be offered to all patients exception of those with high risk of morbidity or mortality. These Guidelines must be considered as an adjunctive tool for decision but they are not substitute of the clinical judgement for the individual patient.

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