Laparoscopic cholecystectomy versus antibiotic therapy for acute cholecystitis in patients over 75 years: Randomized clinical trial and retrospective cohort study

Kivivuori, Antti; Ukkonen, Mika; Ilves, Imre; Vihervaara, Hanna; Zalevskaja, Kristina; Pajari, Jenni; Paajanen, Hannu; Rantanen, Tuomo

doi:10.1177/14574969231178650

Cited by 3 publications

(1 citation statement)

References 32 publications

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“…A randomized clinical trial and retrospective cohort study comparing laparoscopic cholecystectomy versus antibiotic therapy for acute cholecystitis in elderly patients found that the length of hospital stay, and complications were lower in the laparoscopic cholecystectomy group. This trial concluded that laparoscopic cholecystectomy showed be offered to elderly patients with acute cholecystitis [38].…”

Section: Timing Of Cholecystectomy In Acute Cholecystitismentioning

confidence: 99%

Current Management of Acute Cholecystitis: A Narrative Review

Kumar H. R.

2024

AJMAH

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Acute calculous cholecystitis is a common condition that results in upper abdominal pain and this condition is diagnosed with leukocytosis and ultrasound of the abdomen. The Tokyo guidelines have categorized them into three groups according to the severity of the disease. Laparoscopic cholecystectomy is the gold standard in the management of acute cholecystitis with early cholecystectomy being preferred to delayed cholecystectomy. The timing of early cholecystectomy is still being debated. Percutaneous cholecystostomy is used as a bridging procedure for high-risk patients. We have conducted this review article to look at the role of antibiotics, the timing of cholecystectomy and indication of percutaneous cholecystostomy in the management of acute calculous cholecystitis.

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Section: Timing Of Cholecystectomy In Acute Cholecystitismentioning

confidence: 99%

Current Management of Acute Cholecystitis: A Narrative Review

Kumar H. R.

2024

AJMAH

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Indicazioni per la colecistectomia

Weber,

Gutknecht,

Weber

2024

Schweiz. Gastroenterol.

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ZusammenfassungMit 191 Operationen pro 100.000 Einwohner jährlich ist die Cholezystektomie eine der häufigsten Operationen in der Schweiz. Die richtige Indikationsstellung ist zum Teil die grössere Herausforderung als der Eingriff selber. Bei asymptomatischer Cholezystolithiasis ist die Indikation nur in speziellen Situationen gegeben, wie bei der Porzellangallenblase, bei grossen Gallensteinen > 3 cm, bei Gallenblasenpolypen ab 10 mm sowie bei Gallensteinen im Rahmen eines grossen Abdominaleingriffs. Bei typischen biliären Symptomen sollte aufgrund der Beschwerdelast sowie möglichen biliären Komplikationen elektiv operiert werden. Eine Cholezystektomie ist notfallmässig bei der akuten Cholezystitis und zeitnahe bei der milden biliären Pankreatitis zu planen. Ebenso ist bei der Choledocholithiasis eine Cholezystektomie innert 3 Tagen nach Steinsanierung anzustreben. Nach Gallenblasendrainage bei Hochrisikopatienten respektive nach schwerer, nekrotisierender, biliärer Pankreatitis ist die Cholezystektomie im Intervall zu planen, insbesondere bei der Pankreatitis beträgt das ideale Intervall frühestens 8 Wochen.

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Unveiling the therapeutic role of Dachaihu decoction in acute cholecystitis: a comprehensive systematic review and meta-analysis of its efficacy and safety

Liu,

Ma,

Kong

et al. 2024

Front. Pharmacol.

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BackgroundDachaihu decoction (Dachaihu tang) plays a crucial role in treating acute illnesses. Recently, a significant number of clinical studies on Dachaihu decoction for acute cholecystitis (AC) have been published. This study was conducted to assess the efficacy and safety of Dachaihu decoction in patients with this condition.MethodsTo identify relevant randomized controlled trials (RCTs), eight databases and three clinical trial registries were searched from inception to 30 June 2024. Two researchers independently screened and extracted data from eligible studies using EndNote X9 and Microsoft Office Excel 2019. RoB 2.0 was used to assess the risk of bias in the included studies. Stata 17.0 was used for data analysis. Publication bias and its impact on result stability were evaluated using a funnel plot and the “trim-and-fill” method. The quality of evidence was graded using the GRADE assessment system.ResultsThirty-three RCTs involving 2,851 participants were included. The treatment group demonstrated improved clinical efficacy (RR = 1.18; 95% CI = 1.13 to 1.24), significantly reduced length of hospital stay (MD = −1.78 days; 95% CI = –2.02 to −1.53), and the incidence of adverse events (RR = 0.31; 95% CI = 0.20 to 0.48). Additionally, there appeared to be reductions in the time for abdominal pain to resolve (MD = −1.92 days; 95% CI = –2.33 to −1.51), fever to disappear (MD = −1.52 days; 95% CI = –1.90 to −1.14), white blood cell count to return to normal (MD = −2.89 days; 95% CI = –3.32 to −2.46), alanine aminotransferase (ALT) levels (MD = −11.88 U/L; 95% CI = –15.29 to −8.47), aspartate aminotransferase (AST) levels (MD = −8.74 U/L; 95% CI = –9.76 to −7.72), neutrophil percentage (MD = −9.68; 95% CI = –11.33 to −8.03), TNF-α levels (SMD = −2.10 pg/L; 95% CI = –2.43 to −2.78), and certainty of evidence (moderate-to-low certainty).ConclusionDachaihu decoction may be an effective botanical formula for managing AC and a lower incidence of adverse events. However, due to the substantial risk of bias and heterogeneity across the included studies, these findings should be interpreted with caution and require further validation through well-designed, high-quality trials.Systematic Review registrationhttps://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=573332.

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Laparoscopic cholecystectomy versus antibiotic therapy for acute cholecystitis in patients over 75 years: Randomized clinical trial and retrospective cohort study

Cited by 3 publications

References 32 publications

Current Management of Acute Cholecystitis: A Narrative Review

Current Management of Acute Cholecystitis: A Narrative Review

Indicazioni per la colecistectomia

Unveiling the therapeutic role of Dachaihu decoction in acute cholecystitis: a comprehensive systematic review and meta-analysis of its efficacy and safety

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