The ChoCO-W prospective observational global study: Does COVID-19 increase gangrenous cholecystitis?

被引：13

作者：

De Simone, Belinda ^{[1
]}

Abu-Zidan, Fikri M. ^{[2
,3
]}

Chouillard, Elie ^{[1
]}

Di Saverio, Salomone ^{[4
]}

Sartelli, Massimo ^{[5
]}

Podda, Mauro ^{[6
]}

Gomes, Carlos Augusto ^{[7
]}

Moore, Ernest E. ^{[8
]}

Moug, Susan J. ^{[9
]}

Ansaloni, Luca ^{[10
]}

Kluger, Yoram ^{[11
]}

Coccolini, Federico ^{[12
]}

Landaluce-Olavarria, Aitor ^{[13
]}

Estraviz-Mateos, Begona ^{[13
]}

Uriguen-Etxeberria, Ana ^{[13
]}

Giordano, Alessio ^{[14
]}

Luna, Alfonso Palmieri ^{[15
]}

Amin, Luz Adriana Hernandez ^{[15
]}

Hernandez, Adriana Maria Palmieri ^{[15
]}

Shabana, Amanda ^{[16
]}

Dzulkarnaen, Zakaria Andee ^{[17
]}

Othman, Muhammad Asyraf ^{[17
]}

Sani, Mohamad Ikhwan ^{[17
]}

Balla, Andrea ^{[18
]}

Scaramuzzo, Rosa ^{[18
]}

Lepiane, Pasquale ^{[18
]}

Bottari, Andrea ^{[19
]}

Staderini, Fabio ^{[19
]}

Cianchi, Fabio ^{[19
]}

Cavallaro, Andrea ^{[20
]}

Zanghi, Antonio ^{[20
]}

Cappellani, Alessandro ^{[20
]}

Campagnacci, Roberto ^{[21
]}

Maurizi, Angela ^{[21
]}

Martinotti, Mario ^{[22
]}

Ruggieri, Annamaria ^{[22
]}

Jusoh, Asri Che ^{[23
]}

Rahman, Karim Abdul ^{[23
]}

Zulkifli, Anis Suraya M. ^{[23
]}

Petronio, Barbara ^{[24
]}

Matias-Garcia, Belen ^{[25
]}

Quiroga-Valcarcel, Ana ^{[25
]}

Mendoza-Moreno, Fernando ^{[25
]}

Atanasov, Boyko ^{[26
]}

Campanile, Fabio Cesare ^{[27
]}

Vecchioni, Ilaria ^{[27
]}

Cardinali, Luca ^{[28
]}

Travaglini, Grazia ^{[28
]}

Sebastiani, Elisa ^{[28
]}

Chooklin, Serge ^{[29
]}

机构：

[1] Poissy & St Germain Laye Hosp, Dept Emergency Digest & Metab Minimally Invas Sur, Poissy, France

[2] United Arab Emirates Univ, Coll Med & Hlth Sci, Res Off, Al Ain, U Arab Emirates

[3] United Arab Emirates Univ, Al Ain, U Arab Emirates

[4] Santa Maria del Soccorso Hosp, Dept Gen Surg, San Benedetto Tronto, Ascoli Piceno, Italy

[5] Macerata Hosp, Dept Gen Surg, Macerata, Italy

[6] Univ Cagliari, Dept Surg Sci, Cagliari, Italy

[7] Hosp Univ Terezinha Jesus SUPREMA, Fac Ciencia Med & Saude Juiz de Fora, Juiz De Fora, Brazil

[8] Denver Hlth, Ernest E Moore Shock Trauma Ctr, Denver, CO USA

[9] Univ Glasgow, Royal Alexandra Hosp, Paisley & Golden Jubilee Natl Hosp, Dept Surg, Glasgow, Lanark, Scotland

[10] Univ Hosp Pavia, Dept Gen Surg, Pavia, Italy

[11] Rambam Acad Hosp, Dept Gen Surg, Haifa, Israel

[12] Univ Hosp Pisa, Dept Gen & Emergency Surg, Pisa, Italy

[13] Alfredo Espinosa Urduliz Hosp, Urduliz, Spain

[14] Santo Stefano Hosp, Gen Surg Unit, ASL Toscana Ctr, Prato, Italy

[15] Univ Sucre, Clin Santa Maria, Sincelejo, Colombia

[16] John Radcliffe Hosp, Emergency Surg Dept, Oxford, England

[17] Univ Sains Malaysia, Sch Med Sci & Hosp USM, Dept Surg, Kubang Kerian, Kelantan, Malaysia

[18] Hosp San Paolo, UOC Gen & Minimally Invas Surg, Largo Donatori Sangue 1, I-00053 Rome, Italy

[19] AOU Careggi, SOD Chirurg Apparat Digerente, Florence, Italy

[20] Univ Catania, Policlin G Rodolico San Marco Hosp, Dept Surg, Catania, Italy

[21] Carlo Urbani Hosp, UOC Gen Surg, Jesi, AN, Italy

[22] Hosp Ist Citta Pavia, Pavia, Italy

[23] Hosp Sultan Ismail Petra, Dept Gen Surg, Kuala Krai 18000, Kelantan, Malaysia

[24] San Polo Monfalcone, Chirurg Gen & Mininvas, Monfalcone, GO, Italy

[25] Hosp Univ Principe Asturias, Alcala De Henares, Spain

[26] Med Univ Plovdiv, UMHAT Eurohosp, RIMU, Plovdiv, Bulgaria

[27] Osped San Giovanni Decollato Andosilla ASL, Civita Castellana, Viterbo, VT, Italy

[28] Osped Madonna del Soccorso, UOC Chirurg Gen, San Benedetto Tronto, Italy

[29] Lviv Reg Clin Hosp, Lvov, Ukraine

[30] Lorenzo Bonomo Hosp, ASL BAT, Andria, Puglia, Italy

[31] Univ Magna Graecia Med Sch, Mater Domini Hosp, Sci Hlth Dept, Gen Surg Unit, Viale Europa, I-88100 Catanzaro, Italy

[32] Hosp Virgen del Rocio, Emergency Surg Unit, Seville, Spain

[33] Univ Clin Ctr Tuzla, Clin Surg, Tuzla, Bosnia & Herceg

[34] Santa Croce & Carle Hosp, Cuneo, Italy

[35] AOU Citta Salute & Sci, Chirurg Gen Urgenza & PS, Turin, Italy

[36] ASMN IRCCS REGGIO EMILIA, Gen & Emergency Surg, Reggio Emilia, Italy

[37] Univ Padua, Reg Hosp Treviso, DISCOG, Surg Unit 2, Treviso, Italy

[38] Osped San Valentino, UO Chirurg Gen & Urgenza, Treviso, Italy

[39] AUSL Piacenza, Dept Surg, G Da Saliceto Hosp, Piacenza, Italy

[40] Tzaneio Gen Hosp, Dept Surg 3, Styliani Aikaterini Vederaki, Piraeus, Greece

[41] Private Ortadogu Hosp, Clin Surg, Adana, Turkey

[42] Private Medline Hosp, Clin Radiol, Adana, Turkey

[43] Kestel State Hosp, Dept Gen Surg, Bursa, Turkey

[44] Univ Hlth Sci, Bagcilar Training & Res Hosp, Dept Gen Surg, Istanbul, Turkey

[45] Koc Univ, Fac Med, Gen Surg Dept, Istanbul, Turkey

[46] Kavala Gen Hosp, Dept Surg 1, Kavala, Greece

[47] Azienda Osped Univ Ferrara, Dipartimento Chirurg, Arcispedale St Anna, UO Chirurg 1, Ferrara, Italy

[48] Sakarya Training & Res Hosp, Sakarya, Turkey

[49] Lavagna Hosp, Dept Gen Surg ASL 4, Genoa, Italy

[50] Univ Samsun, Samsun Training & Res Hosp, Samsun, Turkey

来源：

WORLD JOURNAL OF EMERGENCY SURGERY | 2022年 / 17卷 / 01期

关键词：

Acute cholecystitis; Cholecystectomy; Gangrene; COVID-19; SARS-CoV-2; Laparoscopy; Surgery; Pandemic; Gangrenous cholecystitis; CHOLECYSTECTOMY; GUIDELINES; MORTALITY;

D O I：

10.1186/s13017-022-00466-4

中图分类号：

R4 [临床医学];

学科分类号：

1002 ; 100602 ;

摘要：

BackgroundThe incidence of the highly morbid and potentially lethal gangrenous cholecystitis was reportedly increased during the COVID-19 pandemic. The aim of the ChoCO-W study was to compare the clinical findings and outcomes of acute cholecystitis in patients who had COVID-19 disease with those who did not.MethodsData were prospectively collected over 6 months (October 1, 2020, to April 30, 2021) with 1-month follow-up. In October 2020, Delta variant of SARS CoV-2 was isolated for the first time. Demographic and clinical data were analyzed and reported according to the STROBE guidelines. Baseline characteristics and clinical outcomes of patients who had COVID-19 were compared with those who did not.ResultsA total of 2893 patients, from 42 countries, 218 centers, involved, with a median age of 61.3 (SD: 17.39) years were prospectively enrolled in this study; 1481 (51%) patients were males. One hundred and eighty (6.9%) patients were COVID-19 positive, while 2412 (93.1%) were negative. Concomitant preexisting diseases including cardiovascular diseases (p < 0.0001), diabetes (p < 0.0001), and severe chronic obstructive airway disease (p=0.005) were significantly more frequent in the COVID-19 group. Markers of sepsis severity including ARDS (p < 0.0001), PIPAS score (p < 0.0001), WSES sepsis score (p < 0.0001), qSOFA (p < 0.0001), and Tokyo classification of severity of acute cholecystitis (p < 0.0001) were significantly higher in the COVID-19 group. The COVID-19 group had significantly higher postoperative complications (32.2% compared with 11.7%, p < 0.0001), longer mean hospital stay (13.21 compared with 6.51 days, p < 0.0001), and mortality rate (13.4% compared with 1.7%, p < 0.0001). The incidence of gangrenous cholecystitis was doubled in the COVID-19 group (40.7% compared with 22.3%). The mean wall thickness of the gallbladder was significantly higher in the COVID-19 group [6.32 (SD: 2.44) mm compared with 5.4 (SD: 3.45) mm; p < 0.0001].ConclusionsThe incidence of gangrenous cholecystitis is higher in COVID patients compared with non-COVID patients admitted to the emergency department with acute cholecystitis. Gangrenous cholecystitis in COVID patients is associated with high-grade Clavien-Dindo postoperative complications, longer hospital stay and higher mortality rate. The open cholecystectomy rate is higher in COVID compared with non -COVID patients. It is recommended to delay the surgical treatment in COVID patients, when it is possible, to decrease morbidity and mortality rates. COVID-19 infection and gangrenous cholecystistis are not absolute contraindications to perform laparoscopic cholecystectomy, in a case by case evaluation, in expert hands.

引用

页数：16

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