Leonardo José Randial Pérez1, Juan Fernando Parra2, Guillermo Aldana Dimas3. 1. Cirugía General, Fundación Universitaria de Ciencias de la Salud (FUCS)-Hospital San José, Bogotá, Colombia. Electronic address: ljrandialp@hotmail.com. 2. Cirugía General, Fundación Universitaria de Ciencias de la Salud (FUCS)-Hospital San José, Bogotá, Colombia. 3. Cirugía General, Unidad de Trasplantes Hospital San José, Fundación Universitaria de Ciencias de la Salud (FUCS), Bogotá, Colombia.
Abstract
BACKGROUND: In mild gallstone pancreatitis, cholecystectomy decreases the risk of recurrence. This should be performed during the initial hospitalization, but even when this is performed, the hospital stay can be prolonged, with an increase in costs and morbidity. The aim of this study is to compare the complication rate between patients who underwent an early cholecystectomy (<48 hours) vs. a late one (>48 hours). MATERIALS AND METHODS: A systematic search was performed in the following data bases: PubMed, EMBASE, LILACS and Scielo. Articles on patients with acute, mild gallstone pancreatitis who required a cholecystectomy during their initial hospitalization were included and compared with those undergoing a late cholecystectomy, in order to evaluate the complications, number of days of hospitalization and need for readmission. The quality of the studies and the risks of bias were evaluated. RESULTS: A total of 580 articles and summaries were identified which included 3 observational studies and a randomized clinical trial. A total of 636 patients who underwent a cholecystectomy during the initial hospitalization were included,. Ten of 207 (4.83%) in the early cholecystectomy group showed some type of complication, and 19 of 429 (4.42%) in the late cholecystectomy group, with a risk difference of -0.0016 IC 95% ([-0.04]-0.04). Three of the included studies should be considered of low quality and one of high quality. No publication bias was evidenced. CONCLUSION: No differences in complication rate were found between patients who underwent an early cholecystectomy versus a late cholecystectomy; nevertheless, further studies should be carried out in order to confirm these findings.
BACKGROUND: In mild gallstone pancreatitis, cholecystectomy decreases the risk of recurrence. This should be performed during the initial hospitalization, but even when this is performed, the hospital stay can be prolonged, with an increase in costs and morbidity. The aim of this study is to compare the complication rate between patients who underwent an early cholecystectomy (<48 hours) vs. a late one (>48 hours). MATERIALS AND METHODS: A systematic search was performed in the following data bases: PubMed, EMBASE, LILACS and Scielo. Articles on patients with acute, mild gallstone pancreatitis who required a cholecystectomy during their initial hospitalization were included and compared with those undergoing a late cholecystectomy, in order to evaluate the complications, number of days of hospitalization and need for readmission. The quality of the studies and the risks of bias were evaluated. RESULTS: A total of 580 articles and summaries were identified which included 3 observational studies and a randomized clinical trial. A total of 636 patients who underwent a cholecystectomy during the initial hospitalization were included,. Ten of 207 (4.83%) in the early cholecystectomy group showed some type of complication, and 19 of 429 (4.42%) in the late cholecystectomy group, with a risk difference of -0.0016 IC 95% ([-0.04]-0.04). Three of the included studies should be considered of low quality and one of high quality. No publication bias was evidenced. CONCLUSION: No differences in complication rate were found between patients who underwent an early cholecystectomy versus a late cholecystectomy; nevertheless, further studies should be carried out in order to confirm these findings.
Authors: Joshua A Greenberg; Jonathan Hsu; Mohammad Bawazeer; John Marshall; Jan O Friedrich; Avery Nathens; Natalie Coburn; Gary R May; Emily Pearsall; Robin S McLeod Journal: Can J Surg Date: 2016-04 Impact factor: 2.089