Dergiler / Batı Karadeniz Tıp Dergisi / 2026 / Cilt: 10 Sayı: 1

Akut kolesistitte konservatif tedavi sonrası interval kolesistektomi bekleyen hastalarda erken yeniden yatışın prediktörleri: Retrospektif kohort çalışması

Predictors of early readmission in patients awaiting interval cholecystectomy after conservative treatment of acute cholecystitis: A retrospective cohort study

Kazım Duman(Department of General Surgery, Sancaktepe Şehit Prof. Dr. İlhan Varank Training and Research Hospital, İstanbul, Türkiye)0009-0002-5258-7504
Sayfa
31–38
Yayın Tarihi
2026-01-21
🏛️Bu makalenin bibliyografik verileri ve tam metin bağlantısı DergiPark üzerinden sağlanmıştır.
DergiPark Kaydı ↗
✨

Yapay Zeka Hızlı Bakış & Çıkarımlar

AI Insight
⚡ TL;DR(1 Cümlede Hızlı Çıkarım)

Bulgular: Çalışmaya 110 hasta dahil edildi (NBG= 78, EBG= 32).

📌 3 Maddede Bu Makale

🎯
Amaç & Hipotez:Amaç: Akut kolesistit tedavisinde interval kolesistektomi yaygın bir strateji olmasına rağmen, bekleme döneminde hastaların önemli bir kısmı komplikasyonlar nedeniyle yeniden hastaneye yatmaktadır.
📊
Temel Bulgular & Veri:Bu çalışma, konservatif tedavi sonrası interval kolesistektomi planlanan hastalarda erken yeniden yatışı etkileyen faktörleri belirlemeyi amaçlamaktadır.
💡
Sonuç & Katkı:Bulgular: Çalışmaya 110 hasta dahil edildi (NBG= 78, EBG= 32).
🔬Tür:Laboratuvar & Saha Deneyi
📍Kapsam:2023 · 110 hasta
⚙️Değişkenler:Akut kolesistit · kolesistektomi · hasta yeniden yatışı

Özet

Amaç: Akut kolesistit tedavisinde interval kolesistektomi yaygın bir strateji olmasına rağmen, bekleme döneminde hastaların önemli bir kısmı komplikasyonlar nedeniyle yeniden hastaneye yatmaktadır. Bu çalışma, konservatif tedavi sonrası interval kolesistektomi planlanan hastalarda erken yeniden yatışı etkileyen faktörleri belirlemeyi amaçlamaktadır. Gereç ve Yöntemler: Bu retrospektif kohort çalışmasında, Ocak 2023-Aralık 2024 tarihleri arasında akut kolesistit tanısıyla yatırılarak konservatif tedavi uygulanan ve interval kolesistektomi planlanan hastalar değerlendirildi. Hastalar, taburculuk sonrası altı hafta içinde yeniden başvurup başvurmamalarına göre Erken Başvuru Grubu (EBG) ve Normal Başvuru Grubu (NBG) olarak sınıflandırıldı. Demografik, klinik ve laboratuvar verileri karşılaştırıldı; risk faktörleri lojistik regresyon analizi ile değerlendirildi. Bulgular: Çalışmaya 110 hasta dahil edildi (NBG= 78, EBG= 32). Çok değişkenli analizde erkek cinsiyet (OR: 5,108; %95 GA: 1,758-14,852; p=0,003) ve diyabetes mellitus (OR: 8,521; %95 GA: 2,933-24,756; p 0.05). Sonuç: Erkek cinsiyet ve diyabetes mellitus, interval kolesistektomi bekleyen hastalarda erken yeniden yatış için bağımsız risk faktörleridir. Bu risk faktörlerine sahip hastalarda uzun süreli konservatif tedavi yerine erken cerrahi müdahale düşünülmelidir.

Abstract

Aim: Although interval cholecystectomy is a common strategy in the treatment of acute cholecystitis, a significant proportion of patients are readmitted due to complications during the waiting period. This study aims to identify factors affecting early readmission in patients scheduled for interval cholecystectomy after conservative treatment. Material and Methods: In this retrospective cohort study, patients hospitalized with acute cholecystitis between January 2023 and December 2024 who received conservative treatment and were scheduled for interval cholecystectomy were evaluated. Patients were classified as Early Presentation Group (EPG) and Normal Presentation Group (NPG) based on whether they were readmitted within six weeks after discharge. Demographic, clinical, and laboratory data were compared; risk factors were evaluated by logistic regression analysis. Results: A total of 110 patients were included in the study (NPG: 78, EPG: 32). In multivariate analysis, male gender (OR: 5.108; 95% CI: 1.758-14.852; p=0.003) and diabetes mellitus (OR: 8.521; 95% CI: 2.933-24.756; p<0.001) were identified as independent predictors of early readmission. Age, inflammatory markers, and gallbladder stone size showed no significant association. Conclusion: Male gender and diabetes mellitus are independent risk factors for early readmission in patients awaiting interval cholecystectomy. Early surgical intervention should be considered instead of prolonged conservative treatment in patients with these risk factors.

🔖

Bu Makaleye Atıf Yap

Duman, K. (2026). Akut kolesistitte konservatif tedavi sonrası interval kolesistektomi bekleyen hastalarda erken yeniden yatışın prediktörleri: Retrospektif kohort çalışması. Batı Karadeniz Tıp Dergisi, Cilt: 10 Sayı: 1, 31–38. https://doi.org/10.29058/mjwbs.1836406

📄 Tam Metin PDF Okuyucu

📄

PDF görüntüleyici hazırlanıyor...

Kaynakça (17)

  1. Yokoe M, Hata J, Takada T, Strasberg SM, Asbun HJ, Wakabayashi G, et al. Tokyo Guidelines 2018: diagnostic criteria and severity grading of acute cholecystitis (with videos). J Hepatobiliary Pancreat Sci. 2018;25(1):41-54. https://doi.org/10.1002/ jhbp.515
  2. Gallaher JR, Charles A. Acute Cholecystitis: A Review. JAMA. 2022;327(10):965-975. https://doi.org/10.1001/ jama.2022.2350
  3. Gurusamy KS, Davidson C, Gluud C, Davidson BR. Early versus delayed laparoscopic cholecystectomy for people with acute cholecystitis. Cochrane Database Syst Rev. 2013;(6):CD005440. https://doi.org/10.1002/14651858. CD005440.pub3
  4. Gutt CN, Encke J, Köninger J, Harnoss JC, Weigand K, Kipfmüller K, et al. Acute cholecystitis: early versus delayed cholecystectomy, a multicenter randomized trial (ACDC study, NCT00447304). Ann Surg. 2013;258(3):385-393. https://doi. org/10.1097/SLA.0b013e3182a1599b
  5. Borzellino G, Khuri S, Pisano M, Mansour S, Allievi N, Ansaloni L, et al. Timing of early laparoscopic cholecystectomy for acute calculous cholecystitis revised: Protocol of a systematic review and meta-analysis of results. World J Emerg Surg. 2020;15:1. https://doi.org/10.1186/s13017-019-0285-7
  6. Blohm M, Österberg J, Sandblom G, Lundell L, Hedberg M, Enochsson L. The Sooner, the Better? The Importance of Optimal Timing of Cholecystectomy in Acute Cholecystitis: Data from the National Swedish Registry for Gallstone Surgery, GallRiks. J Gastrointest Surg. 2017;21(1):33-40. https://doi.org/10.1007/ s11605-016-3223-y
  7. Cao AM, Eslick GD, Cox MR. Early Cholecystectomy Is Superior to Delayed Cholecystectomy for Acute Cholecystitis: a Meta- analysis. J Gastrointest Surg. 2015;19(5):848-857. https:// doi.org/10.1007/s11605-015-2747-x
  8. Mou D, Tesfasilassie T, Hirji S, Ashley SW. Advances in the management of acute cholecystitis. Ann Gastroenterol Surg. 2019;3(3):247-253. https://doi.org/10.1002/ags3.12240
  9. Pathak SJ, Ji H, Nijagal A, Avila P, Dai SC, Arain MA, et al. Index admission cholecystectomy for acute cholecystitis reduces 30-day readmission rates in pediatric patients. Surg Endosc. 2024;38(3):1351-1357. https://doi.org/10.1007/s00464-023- 10632-7
  10. Köstenbauer JK, Gandy RC, Close J, Harvey L. Factors Affecting Early Cholecystectomy for Acute Cholecystitis in Older People- A Population-Based Study. World J Surg. 2023;47(7):1704- 1710. https://doi.org/10.1007/s00268-023-06968-9
  11. Hahm JS, Park JY, Park KG, Ahn YH, Lee MH, Park KN. Gallbladder motility in diabetes mellitus using real time ultrasonography. Am J Gastroenterol. 1996;91(11):2391-2394.
  12. Cho JY, Han HS, Yoon YS, Ahn KS. Risk factors for acute cholecystitis and a complicated clinical course in patients with symptomatic cholelithiasis. Arch Surg. 2010;145(4):329-333. https://doi.org/10.1001/archsurg.2010.35
  13. Ratheesh R, Ulrich MT, Ghozy S, Al-Jaboori M, Nayak SS. The association between diabetes and gallstones: a nationwide population-based cohort study. Prz Gastroenterol. 2023;18(3):292-299. https://doi.org/10.5114/pg.2023.131395
  14. Mahmood F, Akingboye A, Malam Y, Thakkar M, Jambulingam P. Complicated Acute Cholecystitis: The Role of C-Reactive Protein and Neutrophil-Lymphocyte Ratio as Predictive Markers of Severity. Cureus. 2021;13(2):e13592. https://doi. org/10.7759/cureus.13592
  15. Shabanzadeh DM, Sørensen LT, Jørgensen T. Determinants for symptomatic gallstone disease readmissions - results from a cohort with screen-detected gallstone disease. J Visc Surg. 2019;156(5):387-396. https://doi.org/10.1016/j.jviscsurg. 2019.02.005
  16. Velamazán R, López-Guillén P, Martínez-Domínguez SJ, Abad Baroja D, Oyón D, Arnau A, et al. Symptomatic gallstone disease: Recurrence patterns and risk factors for relapse after first admission, the RELAPSTONE study. United European Gastroenterol J. 2024;12(3):286-298. https://doi.org/10.1002/ ueg2.12544
  17. Salama A, Calpin GG, Fuller R, Hill ADK. Clinical predictors of recurrent cholecystitis in non-operative management: A systematic review & meta-analysis. Surgeon. 2025;23(2):106-113. https://doi.org/10.1016/j.surge.2024.11.004