Timing of Cholecystectomy for Acute Calculous Cholecystitis: A Meta-Analysis

Papi, Claudio; Catarci, Marco; D'Ambrosio, Letizia; Gili, Loredana; Koch, Maurizio; Grassi, G; Capurso, Lucio

doi:10.1046/j.1572-0241.2003.04002.x

Cited by 221 publications

(169 citation statements)

References 35 publications

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“…Several studies have shown that performing LC within 72 h of presentation does not increase morbidity and mortality [6,9] . Early LC, furthermore, has been shown to have a lower complication rate, decreased length of stay, decreased cost, and a shorter post-operative recovery period compared to delayed LC [5,7,8,16,17] . The results from a meta-analysis by Papi et al of 12 prospective randomized trials from 1970-2000 (9 addressing open cholecystectomy, 3 addressing LC), showed that there was a decrease in conversion to open procedure when LC was done early (17.6% vs 25.7%) and there were fewer post-operative complications (10.9% vs 15.6%) [17] .…”

Section: Discussionmentioning

confidence: 99%

Factors associated with time to laparoscopic cholecystectomy for acute cholecystitis

Daniak

Peretz²,

Fine³

et al. 2008

WJG

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AIM:To determine patient and process of care factors associated with performance of timely laparoscopic cholecystectomy for acute cholecystitis. METHODS:A retrospective medical record review of 88 consecutive patients with acute cholecystitis was conducted. Data collected included demographic data, co-morbidities, symptoms and physical findings at presentation, laboratory and radiological investigations, length of stay, complications, and admission service ( m e d i c a l o r s u r g i c a l ) . Pa t i e n t s n o t u n d e r g o i n g cholecystectomy during this hospitalization were excluded from analysis. Hierarchical generalized linear models were constructed to assess the association of pre-operative diagnostic procedures, presenting signs, and admitting service with time to surgery. RESULTS:Seventy cases met inclusion and exclusion criteria, among which 12 were admitted to the medical service and 58 to the surgical service. Mean ± SD time to surgery was 39.3 ± 43 h, with 87% of operations performed within 72 h of hospital arrival. In the adjusted models, longer time to surgery was associated with number of diagnostic studies and endoscopic retrograde cholangio-pancreatography (ERCP, P = 0.01) as well with admission to medical service without adjustment for ERCP (P < 0.05). Patients undergoing both magnetic resonance cholangiopancreatography (MRCP) and computed tomography (CT) scans experienced the longest waits for surgery. Patients admitted to the surgical versus medical service underwent surgery earlier (30.4 ± 34.9 vs 82.7 ± 55.1 h, P < 0.01), had less postoperative complications (12% vs 58%, P < 0.01), and shorter length of stay (4.3 ± 3.4 vs 8.1 ± 5.2 d, P < 0.01). CONCLUSION:Admission to the medical service and performance of numerous diagnostic procedures, ERCP, or MRCP combined with CT scan were associated with longer time to surgery. Expeditious performance of ERCP and MRCP and admission of medically stable patients with suspected cholecystitis to the surgical service to speed up time to surgery should be considered.

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Section: Discussionmentioning

confidence: 99%

Factors associated with time to laparoscopic cholecystectomy for acute cholecystitis

Daniak

Peretz²,

Fine³

et al. 2008

WJG

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“…Several other studies too have reported the similar finding ELC being better than DLC. [16][17][18][19] As is evidenced above, most of the studies depict that ELC is better DLC for outcomes such as mortality, morbidity, cost and length of stay. Some studies have even discussed the rare complications that may occur surgically or post operatively.…”

Section: Early Versus Delayed Cholecystectomymentioning

confidence: 99%

Abdominal symptoms and its outcome in gallbladder diseases following routine and emergency cholecystectomy

Giridharan

Madhivadhanam

2017

Int Surg J

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Background: Gallstones constitute for the most common causes of biliary tract diseases in the adult population. The study thus aims to describe the persistence rate of abdominal symptoms in patients after elective cholecystectomy and to understand which symptoms, improve after cholecystectomy.Methods: This observational study is based in Melmaruvatthur Medical College and Research Institute where 69 patients were a part of the study. A pre and post structured questionnaire was used to assess the decrease in the rate of symptoms. After fully informed and written consent the study participants were interviewed questioneired, examined according to the preformed and pretested proforma, patients with a clinical and ultrasonographic diagnosis of gallstones filled out a structured questionnaire on abdominal pain symptoms and functional gastrointestinal disorder before and at six months after cholecystectomy.Results: From the observed chi square value of 9.315 and p value of 0.002 which is less than 0.01 so it is declared that there is an association between the cholecystectomy and symptoms in the post-surgical group.Conclusions: The findings of the study thus suggest that while much of the findings lean toward ELC being better than DLC, the significance values show that no difference exist between the two. The study therefore states that more research is required to ascertain whether ELC or DLC is better at reducing the symptoms associated with gall bladder disease.

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“…cholecystectomy for acute cholecystitis by the experienced surgeons. 5,6,7,8,9 Our study was designed to analyse and compare the results of lap. cholecystectomy in patients with features of acute cholecystitis.…”

Section: Introductionmentioning

confidence: 99%

Laparoscopic Cholecystectomy in Acute Cholecystitis: Our Experience in a Teaching Hospital

P¹,

Deka²

2016

jemds

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BACKGROUNDLaparoscopic cholecystectomy is considered now the gold standard operative procedure for chronic calculous cholecystitis. Acute calculous cholecystitis was considered previously as contraindicated for lap. cholecystectomy. But increasing experience and confidence, laparoscopic cholecystectomy can be extended to acute cholecystitis also with equal efficacy and safety by the experience surgeon.

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Timing of Cholecystectomy for Acute Calculous Cholecystitis: A Meta-Analysis

Abstract: Early operation (open or laparoscopic) does not carry a higher risk of mortality and morbidity compared to delayed operation and should be the preferred surgical approach for patients with acute lithiasic cholecystitis.

Cited by 221 publications

References 35 publications

Factors associated with time to laparoscopic cholecystectomy for acute cholecystitis

Factors associated with time to laparoscopic cholecystectomy for acute cholecystitis

Abdominal symptoms and its outcome in gallbladder diseases following routine and emergency cholecystectomy

Laparoscopic Cholecystectomy in Acute Cholecystitis: Our Experience in a Teaching Hospital

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