Diagnosis and management of gallstone disease: summary of NICE guidance

Warttig, Sheryl; Ward, Stephen; Rogers, Gayla

doi:10.1136/bmj.g6241

Cited by 63 publications

(36 citation statements)

References 1 publication

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“…Although there are several guidelines available to surgeons and physicians on the clinical benefits of ELC, only one 14 has incorporated health economic evidence, based solely on cost-utility analysis. Its limitations were acknowledged in Appendix J of those same guidelines 14 . These included a limited time horizon, assumptions made in the data sources used, and a delay between ELC and DLC longer than that found in most clinical papers (up to 3 times longer).…”

Section: Discussionmentioning

confidence: 99%

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Meta‐analysis of the cost‐effectiveness of early versus delayed cholecystectomy for acute cholecystitis

2019

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Background: Acute calculous cholecystitis (ACC) is a common disease across the world and is associated with significant socioeconomic costs. Although contemporary guidelines support the role of early laparoscopic cholecystectomy (ELC), there is significant variation among units adopting it as standard practice. There are many resource implications of providing a service whereby cholecystectomies for acute cholecystitis can be performed safely. Methods: Studies that incorporated an economic analysis comparing early with delayed laparoscopic cholecystectomy (DLC) for acute cholecystitis were identified by means of a systematic review. A meta-analysis was performed on those cost evaluations. The quality of economic valuations contained therein was evaluated using the Quality of Health Economic Studies (QHES) analysis score. Results: Six studies containing cost analyses were included in the meta-analysis with 1128 patients. The median healthcare cost of ELC versus DLC was €4400 and €6004 respectively. Five studies had adequate data for pooled analysis. The standardized mean difference between ELC and DLC was −2⋅18 (95 per cent c.i. −3⋅86 to −0⋅51; P = 0⋅011; I 2 = 98⋅7 per cent) in favour of ELC. The median QHES score for the included studies was 52⋅17 (range 41-72), indicating overall poor-to-fair quality. Conclusion: Economic evaluations within clinical trials favour ELC for ACC. The limited number and poor quality of economic evaluations are noteworthy.

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Section: Discussionmentioning

confidence: 99%

“…The definition and recommended management of ACC are available in evidence-based guidelines 14,15 . These guidelines include significant support for the role of ELC in managing ACC.…”

Section: Introductionmentioning

confidence: 99%

Meta‐analysis of the cost‐effectiveness of early versus delayed cholecystectomy for acute cholecystitis

2019

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“…Gallstone disease is common and aff ects 10-15% of adults in Western populations [12]. The vast majority of patients remain asymptomatic.…”

Section: Discussionmentioning

confidence: 99%

A gallbladder with the “hidden cystic duct”: A brief overview of various surgical techniques of the Calot’s triangle dissection

Kaczynski¹,

Hilton²

2015

Interventional Medicine and Applied Science

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Abstract:We present a case of a middle-aged female who attended for a routine laparoscopic cholecystectomy as a day case surgery. At operation, she was found to have a distended gallbladder with an unusually prominent distal portion. This has made the dissection of the Calot's triangle challenging. As a result, the "critical view of safety" technique was applied. This allowed for the clear Calot's triangle visualization and identifi cation of the cystic duct and artery. This case highlights that the knowledge of various ways of the cystic duct dissection is essential to every surgeon. Furthermore, this helps to adjust the dissection approach on an individual case bases ensuring avoidance of the common bile duct injuries.

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“…Folgende Leitlinien und Studien waren für die Planung von besonderer Relevanz ▪ DGVS-Leitlinien 2000 und 2007 [12,13] ▪ TG13: Updated Tokyo Guidelines for the management of acute cholangitis and cholecystitis [14] ▪ NICE Clinical Guideline 188 2014 [15] ▪ Neederlandse richtlijn Galsteenlijden 2016 [16] ▪ EASL Clinical Practice Guidelines on the prevention, diagnosis and treatment of gallstones 2016 [17] ▪ British guidelines on the management of common bile duct stones 2017 [18] Als weitere relevante Quelle wurde die IQWIG Gesundheitsinformation Gallensteine 2012 berücksichtigt (http://www.iqwig.de/).…”

Section: üBerarbeitungsstrategie Und Priorisierung Der Empfehlungenunclassified

Leitlinienreport zur aktualisierten S3-Leitlinie der Deutschen Gesellschaft für Gastroenterologie, Verdauungs- und Stoffwechselkrankheiten (DGVS) und der Deutschen Gesellschaft für Allgemein- und Viszeralchirurgie (DGAV) zur Prävention, Diagnostik und Behandlung von Gallensteinen

Jansen

Gutt²,

Jenssen

et al. 2018

Z Gastroenterol

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Diagnosis and management of gallstone disease: summary of NICE guidance

Cited by 63 publications

References 1 publication

Meta‐analysis of the cost‐effectiveness of early versus delayed cholecystectomy for acute cholecystitis

Meta‐analysis of the cost‐effectiveness of early versus delayed cholecystectomy for acute cholecystitis

A gallbladder with the “hidden cystic duct”: A brief overview of various surgical techniques of the Calot’s triangle dissection

Leitlinienreport zur aktualisierten S3-Leitlinie der Deutschen Gesellschaft für Gastroenterologie, Verdauungs- und Stoffwechselkrankheiten (DGVS) und der Deutschen Gesellschaft für Allgemein- und Viszeralchirurgie (DGAV) zur Prävention, Diagnostik und Behandlung von Gallensteinen

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