Acute cholecystitis – a cohort study in a real-world clinical setting (REWO study, NCT02796443)

Figures & data

Table 1 Patients demographics, ASA classification, surgical procedures and hospitalization

	Early, n=138	Intermediate, n=297	Delayed, n=427	Elective, n=861
Age, mean (SD), years	58 (17)	57 (17)	56 (16)	54 (16)
Female sex, n (%)	69 (50)	174 (58.8)	243 (56.9)	565 (65.6)
Male sex, n (%)	69 (50)	123 (41.2)	184 (43.1)	296 (34.4)
ASA I, n (%)a	11 (7.9)	24 (8.1)	57 (13.3)	163 (18.9)
ASA II, n (%)a	99 (71.7)	236 (79.7)	335 (78.5)	660 (76.7)
ASA III, n (%)a	19 (13.8)	35 (11.5)	35 (8.2)	38 (4.4)
ASA IV, n (%)a	9 (6.5)	2 (0.5)	0 (0)	0 (0)
Four-port laparoscopy,a n (%)	112 (81.2)	256 (86.1)	360 (84.3)	717 (83.3)
Single-port laparoscopy,a n (%)	4 (2.9)	11 (3.7)	48 (11.2)	127 (14.8)
Conversion rate to open surgery, n (%)	7 (5.1)	13 (4.4)	6 (1.4)	9 (1.0)
Primarily open surgery, n (%)	15 (10.9)	17 (5.7)	13 (3.1)	8 (0.9)
Operation time,a mean (SD), minutes	68 (40)	61 (29)	68 (34)	53 (23)
Duration of hospitalization after cholecystectomy,a mean (SD), days	6 (6)	5 (5)	4 (2)	3 (2)
Duration of hospitalization before cholecystectomy, mean (SD), days	1 (1)	4 (5)	0 (0)	0 (0)

Notes: Early: Surgery performed within 72 hours of the onset of symptoms. Intermediate: Surgery performed within 10 days on average from the onset of symptoms (for detailed description, see the “Results” section: descriptive data). Delayed: Surgery performed in symptom-free interval (6–12 weeks after the onset of symptoms). Elective: Surgery performed electively in symptomatic cholecystolithiasis without signs of acute cholecystitis. ASA physical status classification system: ASA I: a normal healthy patient; ASA II: a patient with mild systemic disease; ASA III: a patient with severe systemic disease; ASA IV: a patient with severe systemic disease that is a constant threat to life.

a P<0.0001.

Abbreviation: ASA, American Society of Anesthesiologists.

Table 2 Histopathology severity

	Early, n= 138 n (%)	Intermediate, n=297 n (%)	Delayed, n=427 n (%)
0	41 (29.7)	155 (52.2)	311 (72.8)
1	52 (37.7)	81 (27.3)	88 (20.7)
2	29 (21.0)	47 (15.8)	22 (5.2)
3	16 (11.6)	14 (4.7)	6 (1.4)

Notes: Early: Surgery performed within 72 hours of the onset of symptoms. Intermediate: Surgery performed within 10 days on average from the onset of symptoms (for detailed description, see the “Results” section: descriptive data). Delayed: Surgery performed in symptom-free interval (6–12 weeks after the onset of symptoms). 0: Chronic inflammation. 1: Acute erosive inflammation. 2: Acute inflammation with abscess, empyema, ulcero-phlegmonos changes or necrosis. 3: Acute inflammatory covered perforation, with/without peritonitis.

Table 3 Clavien–Dindo complication score

Clavien	Early, n=138 n (%)	Intermediate, n=297 n (%)	Delayed, n=427 n (%)	Elective, n=861 n (%)
0	99 (71.7)	248 (83.5)	382 (89.7)	804 (93.4)
1	7 (5.1)	17 (5.7)	13 (3.1)	28 (3.3)
2	16 (11.6)	18 (6.1)	23 (5.2)	22 (2.6)
3	1 (0.7)	6 (2.0)	4 (1.0)	4 (0.5)
4	11 (8.0)	7 (2.4)	5 (1.2)	3 (0.3)
5	4 (2.9)	1 (0.3)	0 (0.0)	0 (0.0)

Notes: Early: Surgery performed within 72 hours of the onset of symptoms. Intermediate: Surgery performed within 10 days on average from onset of symptoms (for detailed description, see the “Results” section: descriptive data). Delayed: Surgery performed in symptom-free interval (6–12 weeks after the onset of symptoms). Elective: Surgery performed electively in symptomatic cholecystolithiasis without signs of acute cholecystitis.

Figure 1 Clavien–Dindo complication score by the operation group.