Cholecystectomy 7 days vs 4 weeks after mild biliary pancreatitis; looking a decrease the incidence of persistent choledocholithiasis and ERCP: A multicentric randomized clinical trial

Facundo, Helena; Montoliu, Ruth Ribas; Llanos, Daniel Rolando Coronado; Naval, G; Llàcer-Millán, Erik; Gordo, Sandra Lopez; Bosch, Judit Hermoso; Rodríguez, Sergio López; Martı́n-Baranera, Montserrat; Martínez, Sergio González

doi:10.1016/j.ijsu.2021.106207

Cited by 4 publications

(3 citation statements)

References 24 publications

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“…A comprehensive literature search initially identi ed 23,904 relevant articles, which were narrowed down to 15 eligible studies involving 1616 patients in the nal meta-analysis. [19][20][21][22][23][24][25][26][27][28][29][30][31][32][33] The PRISMA ow diagram illustrating this process is depicted in Fig. 1.…”

Section: Study Selection and Characteristicsmentioning

confidence: 99%

“…[30] Furthermore, four studies exhibited incomplete outcome data. Speci cally, Jee's trial [23] and Facundo's trial [33] rated as having "some concerns", whereas Noel's trial [25] and Omar's trial [26] were classi ed as having a "high" risk for performance bias. Nevertheless, it's noteworthy that the risk of deviation from intended interventions, outcome measurements, and selective reporting were deemed "low" across all eligible studies.…”

Section: Risk Of Biasmentioning

confidence: 99%

“…[17,18] Although several randomized controlled trials (RCTs) have compared ELC versus DLC in MABP patients, most had limited sample sizes and inconsistent reporting of outcomes. [19][20][21][22][23][24][25][26][27][28][29][30][31][32][33] To address these knowledge gaps, we conducted a comprehensive meta-analysis of all available RCTs comparing the timing of LC in patients with MABP to generate high-quality evidence and guide clinical practice.…”

Section: Introductionmentioning

confidence: 99%

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Early versus Delayed Laparoscopic Cholecystectomy for Mild Acute Biliary Pancreatitis: A Systematic Review and Meta-Analysis

Zhou,

Zhang,

et al. 2023

Preprint

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Background Laparoscopic cholecystectomy (LC) is widely accepted as the definitive therapeutic approach for MABP, primarily aiming to reduce recurrent biliary complications. However, the optimal timing of LC remains a matter of debate. The aim of this study was to evaluate the efficacy and safety of early laparoscopic cholecystectomy (ELC) versus delayed laparoscopic cholecystectomy (DLC) in patients with mild acute biliary pancreatitis (MABP). Methods The PubMed, Embase, Scopus, and CENTRAL databases were systematically searched for randomized clinical trials (RCTs) comparing ELC with DLC in patients with MABP from inception to August 1, 2023. The primary outcome was recurrent biliary events. Secondary outcomes included postoperative complications, readmissions, and length of stay (LOS). The pooled risk ratio (RR) or standardized mean difference (SMD) of data was calculated using the random-effects model. Results Fifteen RCTs with 1616 patients enrolled between 2010 and 2022 were included. High-certainty evidence from nine RCTs demonstrated a significantly lower risk of recurrent biliary events in patients who underwent ELC during the waiting time compared to DLC (RR=0.128[0.063, 0.262], P<0.001). For secondary outcomes, ELC in patients with MABP was associated with a significantly lower readmission rate (RR=0.382[0.182, 0.801], P=0.011) and shorter LOS (SMD=-2.026[-2.854, -1.198], P<0.001) than DLC. Subgroup analysis indicated that patients with ELC had a significantly lower rate of postoperative complications in accordance with the Atlanta criteria, MABP, and >4 weeks subgroup. Conclusions ELC emerges as a generally safe and effective strategy in reducing recurrent biliary events, postoperative complications, readmission, and length of stay for patients with MABP.

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Section: Study Selection and Characteristicsmentioning

confidence: 99%

Section: Risk Of Biasmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Early versus Delayed Laparoscopic Cholecystectomy for Mild Acute Biliary Pancreatitis: A Systematic Review and Meta-Analysis

Zhou,

Zhang,

et al. 2023

Preprint

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Diagnosis and Management of Acute Pancreatitis

Trikudanathan,

Yazici,

Evans Phillips

et al. 2024

Gastroenterology

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External application of mirabilite before surgery can reduce the inflammatory response and accelerate recovery in mild acute biliary pancreatitis

Cai

Luo

et al. 2023

BMC Gastroenterol

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Objective Mild acute biliary pancreatitis (MABP) is one of the most common diseases that require surgical treatment. Previous studies have focused on the timing of laparoscopic cholecystectomy (LC) for MABP. However, the impact of its inflammatory response process on the clinical outcome has been rarely reported. This study aimed to investigate the effect of preoperative external application of mirabilite on the inflammatory response and clinical efficacy in MABP. Methods Medical records of patients undergoing LC due to MABP from November 2017 to June 2022 were retrospectively reviewed. Prior to surgery, the control group received the same baseline treatment measures as the study group. The difference was the addition of external application of mirabilite in the study group. Results A total of 75 patients were included in the final analysis: 38 patients in the mirabilite group and 37 patients in the control group. Repeated-measures ANOVA (P < 0.01) showed that the white blood cell count (WBC) on the 3rd day of admission and the WBC and C-reactive protein (CRP) level on the 5th day of admission decreased rapidly and significantly in the mirabilite group, compared with the control group. The mirabilite group had earlier anal exhaust time. The number of patients in the mirabilite group and control group with gallbladder wall ≥ 3 mm before the operation was 16 (42.11%) vs. 24 (64.86%), p = 0.048, respectively; and the number of cases with surgical drain placement was 2 (5.26%) vs. 9 (24.32%), p = 0.020, respectively. The intraoperative modified American Fertility Society (mAFS) score of adhesions was lower in the mirabilite group (1.08 ± 0.59 points) than in the control group (1.92 ± 0.60 points), p = 0.000. The mirabilite group, compared to the control group, p = 0.000, had a short waiting time for surgery (5.68 ± 0.70 days vs. 6.54 ± 0.59 days), short operation time (38.03 ± 5.90 min vs. 48.51 ± 8.37 min), and reduced hospitalization time (8.95 ± 0.96 days vs. 9.84 ± 1.07 days). Conclusion This study demonstrated that preoperative external application of mirabilite can reduce the inflammatory response, decrease the edema and peribiliary adhesions at the surgical site, and accelerate recovery in MABP.

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Cholecystectomy 7 days vs 4 weeks after mild biliary pancreatitis; looking a decrease the incidence of persistent choledocholithiasis and ERCP: A multicentric randomized clinical trial

Cited by 4 publications

References 24 publications

Early versus Delayed Laparoscopic Cholecystectomy for Mild Acute Biliary Pancreatitis: A Systematic Review and Meta-Analysis

Early versus Delayed Laparoscopic Cholecystectomy for Mild Acute Biliary Pancreatitis: A Systematic Review and Meta-Analysis

Diagnosis and Management of Acute Pancreatitis

External application of mirabilite before surgery can reduce the inflammatory response and accelerate recovery in mild acute biliary pancreatitis

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