Laparoscopic Cholecystectomy vs Open Cholecystectomy in the Treatment of Acute Cholecystitis

Luján, Juan; Parrilla, P.; Robles, R.; Marín, P Pablo; Torralba, José Antonio; Garcia-Ayllon, J.

doi:10.1001/archsurg.133.2.173

Cited by 205 publications

(153 citation statements)

References 6 publications

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“…A case series examining patients with AC, gallbladder gangrene, hydrops and gallbladder empyema observed a conversion rate of 20.5% and a morbidity of 17% (Eldar, 1998). A retrospective case series of LC for AC found similar results to those described for cholecystolithiasis, except in operating time and conversion rate which were significantly higher (Lujan, 1995), and another larger case series described statistical diferences of conversion rate between patients with AC vs. Chronic cholecystitis (20.6% vs 4.2%) (Tan, 2006)…”

Section: (Treatment Studies 2b)mentioning

confidence: 62%

“…Low quality: it very likely that future studies change our confidence in the estimate of effect, therefore our confidence is low. Table. 2001; Elder, 1996;Finan, 2006;Zacks, 2002;Collet, 1997;Ibrahim, 2006;Weber, 2003;Feldman, 1994;Perez Lara, 2006;Sungler, 2000;Daradkeh, 1999;Ji, 2005;Fernandes, 2000;Palanivelu, 2006;da Silveira, 2006;Gurusamy, 2006;Chandler, 2000;Kiviluoto, 1998;Glavic, 2001;Eldar, 1998;Lujan, 1995;Tan, 2006;Perez-Morales, 2005;Bagia, 2001;Schafer, 2003;Kwon, 2001;Woods, 1996).…”

Section: Discussionmentioning

confidence: 99%

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Effectiveness of Laparoscopic Surgery for Gallstones and Common Bile Duct Lithiasis: a Systematic Overview

et al. 2010

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SUMMARY:The aim of the present study was to evaluate the available evidence on the effectiveness of laparoscopic surgery for treating gallstones and common bile duct lithiasis (CBDL). A systematic overview was performed. Medline, EMBASE and The Cochrane Library were searched (1998)(1999)(2000)(2001)(2002)(2003)(2004)(2005)(2006)(2007)(2008). Systematic reviews (SR), clinical practice guidelines (CPG), randomised clinical trials (RCT) and observational studies were included. Internal validity and overall quality of the evidence were assessed. The available evidence was classified according to the Oxford Centre for Evidence Based Medicine proposal. 87 studies were included in this review (12 SR, 23 RCT, 3 CPG, 13 cohort studies, 3 cross-sectional studies, 2 case and control studies and 31 case series). Compared with open cholecystectomy, laparoscopic cholecystectomy (LC) is associated with shorter operating time, shorter hospital stay and better quality of life (high quality evidence). The use of antibiotic prophylaxis does not appear to reduce the infection rate in low-risk patients (high quality evidence). Although many techniques have been advocated to perform LC their effectiveness is as yet inconclusive (low-quality evidence). Two-stage surgery is the most appropriate strategy for high-risk patients with CBDL (high-quality evidence). Mortality is similar to open surgery, as the effectiveness is similar to that of endoscopic treatment (high-quality evidence). As a conclusion we can state that the evidence concerning the effectiveness of laparoscopic surgery for gallstones and CBDL is scarce and of low methodological quality and that better quality studies are warranted to assess these techniques more adequately.

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Section: (Treatment Studies 2b)mentioning

confidence: 62%

Section: Discussionmentioning

confidence: 99%

Effectiveness of Laparoscopic Surgery for Gallstones and Common Bile Duct Lithiasis: a Systematic Overview

et al. 2010

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“…The latter underlines the need for early intervention, initiated within 72 hours after onset of symptoms. [27][28][29][30][31][32] Other proposals to decrease conversion and complication rates include percutaneous trans-hepatic gall bladder drainage followed by elective cholecystectomy 11 and laparoscopic subtotal cholecystectomy.…”

Section: Discussionmentioning

confidence: 99%

Empyema of the Gall Bladder: Reappraisal in the Laparoscopy Era

2003

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Background: In evaluations of laparoscopic cholecystectomy for acute cholecystitis, the role of this technique specifically for empyema of the gall bladder has not been separately addressed. Therefore, we describe the demographic characteristics, clinical and laboratory findings, management and outcome of patients presenting with empyema of the gall bladder who were treated with open cholecystectomy or laparoscopic cholecystectomy. Patients and Methods: Our retrospective evaluation included 1449 patients who underwent cholecystectomy over 88 months, including a 30-month period when open cholecysectomy was the standard operation and a 58-month period when laparoscopic cholecysectomy became the standard operation for acute and chronic cholecystitis. Results: Of the 1449 cholecysectomies, 29 cases proved to have empyema, an incidence of 2%. Males constituted 48.3% of the patients (vs. 22% for the whole cholecystectomy group, P≤0.005) and the average age was 54.6 years (vs. 43 years for the whole cholecystectomy group, P≤0.005). The clinical picture was indistinguishable from other forms of acute cholecystitis. Laparoscopic cholecystectomy was attempted for all the patients in the laparoscopy era with a conversion rate of 42%, significantly higher than other forms of gall bladder diseases (P=0.002). Conclusion: Empyema of the gall bladder is more often encountered in males and the elderly. The clinical picture is indistinguishable from other forms of acute cholecystitis and a preoperative diagnosis is difficult. Early laparoscopic cholecystectomy is advisable for all patients with acute cholecystitis. A higher conversion rate is expected for patients with empyema.

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“…Laparoscopic approach should initially be attempted except in cases of absolute anesthesiology contraindications or septic shock. Many prospective trials have demonstrated that the laparoscopic cholecystectomy is a safe and effective treatment for ACC [102][103][104][105][106]. A recently published meta-analysis demonstrated that laparoscopic cholecystectomy in ACC [107] is the preferred approach having lower mortality and morbidity, significantly shorter post-operative hospital stay, and reduced rate of pneumonia and wound infections, compared with the open technique.…”

Section: Statement 12mentioning

confidence: 99%

Management of Intra-Abdominal Infections

Moore

2016

Common Problems in Acute Care Surgery

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This paper reports on the consensus conference on the management of intra-abdominal infections (IAIs) which was held on July 23, 2016, in Dublin, Ireland, as a part of the annual World Society of Emergency Surgery (WSES) meeting. This document covers all aspects of the management of IAIs. The Grading of Recommendations Assessment, Development and Evaluation recommendation is used, and this document represents the executive summary of the consensus conference findings.

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Laparoscopic Cholecystectomy vs Open Cholecystectomy in the Treatment of Acute Cholecystitis

Abstract: To compare the results of laparoscopic cholecystectomy (LC) with those of open cholecystectomy (OC) in the treatment of acute cholecystitis.

Cited by 205 publications

References 6 publications

Effectiveness of Laparoscopic Surgery for Gallstones and Common Bile Duct Lithiasis: a Systematic Overview

Effectiveness of Laparoscopic Surgery for Gallstones and Common Bile Duct Lithiasis: a Systematic Overview

Empyema of the Gall Bladder: Reappraisal in the Laparoscopy Era

Management of Intra-Abdominal Infections

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