• Chovav Handler, Uri Kaplan, Dan Hershko, Ossama Abu-Hatoum, and Doron Kopelman.
• Department of General Surgery, Ziv Medical Center, Rambam st, 13100, Tzfat, Israel. chovav.h@ziv.gov.il.
• Eur J Trauma Emerg Surg. 2023 Apr 1; 49 (2): 115711611157-1161.

IntroductionPatients who are admitted with acute cholecystitis (AC) and do not undergo urgent cholecystectomy, are usually referred for interval cholecystectomy. Many do not have surgery for various reasons, and some of those do not suffer from any recurrent symptoms. The primary objective of this study was to assess the rate and nature of recurrent gallstone-related events in this population over a long period, and its association with demographic and clinical parameters. A secondary objective was to assess the reasons for not undergoing surgery.MethodsThis is a retrospective cohort study, where the study group were adult patients admitted with AC. Patients that have suffered recurrent episodes were compared with those who did not. A control group of patients that had undergone cholecystectomy following an admission with AC was used for comparison. Demographic and clinical parameters were recorded for all patients, and the association with a recurrent episode was analyzed using univariate analysis.ResultsThe study population was 197 patients. The group of patients who did not undergo surgery were significantly older (68.7 vs 54.2) and sicker (ASA > 3 50% vs 19%). The rate of recurrent episodes in the study group was 38.5%, and it was not found to be associated with the studied parameters. There was a trend towards higher gallstone disease specific mortality in the study group (5.5% vs 1.45% p = 0.062).ConclusionsThis is a study of long-term follow-up of patients following an episode of AC we showed that the rate of recurrent episodes is quite high and involves severe inflammatory diseases, such as obstructive jaundice and pancreatitis.© 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany.

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