Du-Jiang Yang1, Hui-Min Lu1, Qiang Guo2, Shan Lu1, Ling Zhang1, Wei-Ming Hu1. 1. 1 Department of Pancreatic Surgery, West China Hospital, Sichuan University , Chengdu, China . 2. 2 Department of Vascular Surgery, West China Hospital, Sichuan University , Chengdu, China .
Abstract
AIM: To compare the safety of cholecystectomy in early laparoscopic cholecystectomy (ELC) and delayed laparoscopic cholecystectomy (DLC). METHODS: We systematically searched PubMed, EMBASE, and Cochrane Library for studies that were published from January 1992 to March 2017. We included studies on patients with mild biliary pancreatitis and that reported the timing of cholecystectomy and the number of complications, readmissions, and conversion to open cholecystectomy. Moreover, we assessed the quality and bias risks of the included studies. RESULTS: After screening 4651 studies, we included 3 randomized clinical trials and 10 retrospective studies. The included studies described 2291 patients, of whom 1141 (49.8%) underwent ELC and 1150 (50.2%) underwent DLC. The reported rate of complications for ELC (6.8%) was lower than that for DLC (13.45%). The reported rate of readmission for ELC was lower than that for DLC. The length of hospital stay was longer with DLC than with ELC. ELC and DLC did not have significantly different rates of conversion to open cholecystectomy and duration of surgery. CONCLUSION: This meta-analysis provides evidence that ELC is better than DLC in many aspects for acute mild pancreatitis patients undergoing laparoscopic cholecystectomy. ELC associated with few complications and readmissions, as well as a short length of hospital stay.
AIM: To compare the safety of cholecystectomy in early laparoscopic cholecystectomy (ELC) and delayed laparoscopic cholecystectomy (DLC). METHODS: We systematically searched PubMed, EMBASE, and Cochrane Library for studies that were published from January 1992 to March 2017. We included studies on patients with mild biliary pancreatitis and that reported the timing of cholecystectomy and the number of complications, readmissions, and conversion to open cholecystectomy. Moreover, we assessed the quality and bias risks of the included studies. RESULTS: After screening 4651 studies, we included 3 randomized clinical trials and 10 retrospective studies. The included studies described 2291 patients, of whom 1141 (49.8%) underwent ELC and 1150 (50.2%) underwent DLC. The reported rate of complications for ELC (6.8%) was lower than that for DLC (13.45%). The reported rate of readmission for ELC was lower than that for DLC. The length of hospital stay was longer with DLC than with ELC. ELC and DLC did not have significantly different rates of conversion to open cholecystectomy and duration of surgery. CONCLUSION: This meta-analysis provides evidence that ELC is better than DLC in many aspects for acute mild pancreatitispatients undergoing laparoscopic cholecystectomy. ELC associated with few complications and readmissions, as well as a short length of hospital stay.
Authors: Pablo Giuffrida; David Biagiola; Agustín Cristiano; Victoria Ardiles; Martín de Santibañes; Rodrigo Sanchez Clariá; Juan Pekolj; Eduardo de Santibañes; Oscar Mazza Journal: Updates Surg Date: 2020-02-03
Authors: Krislynn M Mueck; Shuyan Wei; Claudia Pedroza; Karla Bernardi; Margaret L Jackson; Mike K Liang; Tien C Ko; Jon E Tyson; Lillian S Kao Journal: Ann Surg Date: 2019-09 Impact factor: 12.969