Index versus delayed cholecystectomy in mild gallstone pancreatitis: results of a randomized controlled trial

Noel, Rozh; Arnelo, Urban; Lundell, Lars; Hammarqvist, Folke; Jumaa, Hanaz; Enochsson, Lars; Sandblom, Gabriel

doi:10.1016/j.hpb.2018.03.016

Cited by 34 publications

(59 citation statements)

References 23 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Intraoperative complications were reported by all studies. There was no statistically significant difference in the rate of intraoperative complications between EC (4 of 317, 1·3 per cent) and DC (7 of 306, 2·3 per cent) groups.…”

Section: Resultsmentioning

confidence: 79%

“…Postoperative complications were reported by all studies; there was no significant difference between patients who had EC (15 of 317, 4·7 per cent) and those who underwent DC (18 of 306, 5·9 per cent) (pooled OR 0·78, 95 per cent c.i. 0·38 to 1·62) ( Fig .…”

Section: Resultsmentioning

confidence: 87%

“…Biliary complications requiring readmission to hospital were reported in all studies. Some 3·1 per cent (10 of 318) of patients who had EC required readmission for a biliary complication, compared with 19·6 per cent (61 of 311) of those who had DC.…”

Section: Resultsmentioning

confidence: 93%

“…Five RCTs were identified ( Fig . ), which included 629 patients (318 in the EC group and 311 in the DC group).…”

Section: Resultsmentioning

confidence: 99%

“…Three RCTs defined EC as a procedure that was performed within 72 h of randomization, on index admission, and the remaining two RCTs defined EC as being done during index hospital admission. DC was defined as an interval procedure performed 6 weeks after index admission in three RCTs, and as 25–30 days after the index admission in the remaining two RCTs. The detailed definitions of mild gallstone pancreatitis used by each study are presented in Table .…”

Section: Resultsmentioning

confidence: 99%

See 4 more Smart Citations

Meta-analysis of randomized clinical trials of early versus delayed cholecystectomy for mild gallstone pancreatitis

Moody

Adiamah

Yanni

et al. 2019

British Journal of Surgery

View full text Add to dashboard Cite

Background: Gallstones account for 30-50 per cent of all presentations of acute pancreatitis. While the management of acute pancreatitis is usually supportive, definitive treatment of gallstone pancreatitis is cholecystectomy. Guidelines from the British Society of Gastroenterology suggest definitive treatment on index admission or within 2 weeks of discharge, whereas joint recommendations from the International Association of Pancreatology and the American Pancreatic Association recommend definitive treatment on index admission. Evidence suggests that uptake of these guidelines is low.Methods: Embase, MEDLINE and Cochrane databases were searched for RCTs investigating early versus delayed cholecystectomy in patients with a confirmed diagnosis of mild gallstone pancreatitis. The pooled synthesis was undertaken using a random-effects meta-analysis of the primary outcome of recurrent biliary complications causing hospital readmission. Secondary outcomes included intraoperative and postoperative complications, and total length of hospital stay (LOS). All analyses were performed using RevMan5 software. Results: Five RCTs were identified, which included 629 patients (318 in the early cholecystectomy (EC) group and 311 in the delayed cholecystectomy (DC) group). Recurrent biliary events that required readmission were reduced in patients undergoing EC compared with the number in patients having DC(odds ratio (OR) 0⋅17, 95 per cent c.i. 0⋅09 to 0⋅33). There was no difference in the rate of intraoperative (OR 0⋅58, 0⋅17 to 1⋅92) or postoperative (OR 0⋅78, 0⋅38 to 1⋅62) complications.Conclusion: EC following mild gallstone pancreatitis does not increase the risk of intraoperative or postoperative complications, but reduces the readmission rate for recurrent biliary complications.

show abstract

Section: Resultsmentioning

confidence: 79%

Section: Resultsmentioning

confidence: 87%

Section: Resultsmentioning

confidence: 93%

“…Five RCTs were identified ( Fig . ), which included 629 patients (318 in the EC group and 311 in the DC group).…”

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 3 more Smart Citations

Meta-analysis of randomized clinical trials of early versus delayed cholecystectomy for mild gallstone pancreatitis

Moody

Adiamah

Yanni

et al. 2019

British Journal of Surgery

View full text Add to dashboard Cite

show abstract

National Trends in Cholecystectomy and Endoscopic Retrograde Cholangiopancreatography During Index Hospitalization for Mild Gallstone Pancreatitis

et al. 2021

View full text Add to dashboard Cite

Background Guidelines call for cholecystectomy during the index hospitalization for patients with gallstone pancreatitis. Therefore, the study sought to determine the trends for cholecystectomy and Endoscopic Retrograde Cholangiopancreatography (ERCP) for mild gallstone pancreatitis. Methods A retrospective analysis of the 2010-2018 Nationwide Readmission Database (NRD) was performed to identify patients with mild gallstone pancreatitis. The primary aim was to identify the trends in the use of cholecystectomy in these patients, and the secondary aim was to assess if ERCP alone was protective against readmission. Results A total of 510,470 patients with mild gallstone pancreatitis were identified. There has been an increasing trend in ERCP use (25% in 2018 vs. 22% in 2010; p-0.001) and a decline in cholecystectomy (37% in 2018 vs. 46% in 2010; p-0.001) prior to discharge. Multivariate analysis revealed higher 30-day readmission for patients who underwent ERCP without cholecystectomy (odds ratio1.3; 95% confidence interval, 1.1-3.5) during the index admission. Conclusions There has been a decline in the use of cholecystectomy during index hospitalization for mild gallstone pancreatitis. In addition, ERCP was not protective against 30-day readmission from mild gallstone pancreatitis.

show abstract

Early Versus Delayed Cholecystectomy for Acute Biliary Pancreatitis: A Systematic Review and Meta‐Analysis

et al. 2022

View full text Add to dashboard Cite

Background Recommendations regarding the timing of cholecystectomy for acute biliary pancreatitis (ABP) require a systematic summary of current evidence to guide clinical practice. We conducted a systematic review and metaanalysis of randomized controlled trials (RCTs) comparing early cholecystectomy (EC) versus delayed cholecystectomy (DC) in patients with ABP. Methods We searched databases Medline, Embase, SCOPUS, Web of Science and Cochrane CENTRAL for randomized controlled trials addressing this question. Pairs of reviewers abstracted data and assessed the risk of bias in included studies. A random-effects meta-analysis was done to study the effect of the timing of cholecystectomy on outcomes of interest in patients with ABP. GRADE methodology was used to rate the quality in the body of evidence for each outcome as high, moderate, low, or very low. Results 11 randomized trials (1176 participants) were included. High-quality evidence from seven RCTs (867 participants) showed a statistically significant reduction in the risk for recurrent biliary events in favour of early cholecystectomy (RR 0.10, 95% CI 0.05 to 0.19, I 2 = 0%). High-quality evidence from five trials was in favour of early cholecystectomy with a significant reduction in the risk 7of recurrent pancreatitis (RAP) in comparison to delayed cholecystectomy (RR 0.21, 95% CI 0.09 to 0.51, I 2 = 0%). Conclusion This review showed that EC has definite advantages over DC in terms of reducing recurrent pancreaticobiliary events and LOS following mild ABP. However, more RCTs are required to study the role of EC in patients with moderately-severe and severe ABP. Trial Registration Protocol registered on Prospero (CRD42020192823).

show abstract

Index versus delayed cholecystectomy in mild gallstone pancreatitis: results of a randomized controlled trial

Abstract: clinicaltrials.gov (ID: NCT02630433).

Cited by 34 publications

References 23 publications

Meta-analysis of randomized clinical trials of early versus delayed cholecystectomy for mild gallstone pancreatitis

Meta-analysis of randomized clinical trials of early versus delayed cholecystectomy for mild gallstone pancreatitis

National Trends in Cholecystectomy and Endoscopic Retrograde Cholangiopancreatography During Index Hospitalization for Mild Gallstone Pancreatitis

Early Versus Delayed Cholecystectomy for Acute Biliary Pancreatitis: A Systematic Review and Meta‐Analysis

Contact Info

Product

Resources

About