BACKGROUND: Laparoscopic cholecystectomy is considered nowadays as the standard management of acute @entity2679 (AC). However, results from multicentric studies in the general surgical community are still lacking. METHODS: A prospective multicenter survey of surgical management of AC @entity1 was conducted over a 2-year period in Belgium. Operative features and @entity1 ' clinical outcome were recorded. The impact of independent predictive factors on the choice of surgical approach, the risk of conversion, and the occurrence of @entity260 was studied by multivariate logistic regression analysis. RESULTS: Fifty-three surgeons consecutively and anonymously included 1,089 @entity1 in this prospective study. A primary open approach was chosen in 74 @entity1 (6.8%), whereas a laparoscopic approach was the first option in 1,015 @entity1 (93.2%). Independent predictive factors for a primary open approach were previous history of upper abdominal surgery [odds ratio (OR) 4.13, p < 0.001], @entity1 age greater than 70 years (OR 2.41, p < 0.05), surgeon with more than 10 years' experience (OR 2.08, p = 0.005), and @entity2679 (OR 1.71, p < 0.05). In the laparoscopy group, 116 @entity1 (11.4%) required conversion to laparotomy. Overall, 38 @entity1 (3.5%) presented biliary complications and 49 had other local complications (4.5%). Incidence of @entity1157 was 1.2% in the whole series, 2.7% in the open group, and 1.1% in the laparoscopy group. Sixty @entity1 had general complications (5.5%). The overall mortality rate was 0.8%. All @entity1 who died were in poor general condition [American Society of Anesthesiologists (ASA) III or IV]. CONCLUSIONS: Although laparoscopic cholecystectomy is currently considered as the standard treatment for acute @entity2679 , an open approach is still a valid option in more @entity1442 . However, overall mortality and incidence of @entity1157 remain high.

Surgical management of acute XXXX : results of a 2-year prospective multicenter survey in Belgium.

@entity1 :: ('9606', 'Species') :: ['patients', 'patient'] @entity1157 :: ('MESH:D001649', 'Disease') :: ['bile duct injury'] @entity260 :: ('MESH:D011183', 'Disease') :: ['postoperative complications'] @entity1442 :: ('MESH:D020178', 'Disease') :: ['advanced disease'] @entity2679 :: ('MESH:D002764', 'Disease') :: ['gangrenous cholecystitis', 'cholecystitis']
@entity2679 :: (MESH:D002764,Disease) :: ['cholecystitis']
