Diagnosis and treatment of acute calculus cholecystitis: WSES 2020 Guideline
Antibiotic Treatment of ACC
- In uncomplicated ACC, we recommend against the routine use of postoperative antibiotics when the focus of infection is controlled by cholecystectomy.
- In complicated ACC, prescribing the antimicrobial regimen is recommended based on the presumed pathogens involved and the risk factors for major resistance patterns.
- In patients with complicated ACC and patients at high risk for antimicrobial resistance, the researchers recommend adapting the targeted antibiotic regimen to the results of microbiological analysis, ensuring adequate antimicrobial coverage.
"ELC has a central role in the management of patients with ACC. The value of surgical treatment for high-risk patients should lead to a distinction between high-risk patients and patients who are not suitable for surgery. Further evidence on the role of clinical judgement and the use of clinical scores as adjunctive tools to guide treatment of high-risk patients and patients who are not suitable for surgery is required. The development of local policies for safe laparoscopic cholecystectomy is recommended," wrote the authors.
Reference:
2020 World Society of Emergency Surgery updated guidelines for the diagnosis and treatment of acute calculus cholecystitis, is published in the World Journal of Emergency Surgery.
DOI: https://wjes.biomedcentral.com/articles/10.1186/s13017-020-00336-x
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