Yunxiao Lyu1,2, Yunxiao Cheng3, Bin Wang3, Sicong Zhao3, Liang Chen3. 1. Department of Hepatobiliary Surgery, Dongyang People's Hospital, Dongyang, 322100, Zhejiang, China. lvyunxiao1986@gmail.com. 2. Department of General Surgery, Dongyang People's Hospital, 60 West Wuning Road, Dongyang, 322100, Zhejiang, China. lvyunxiao1986@gmail.com. 3. Department of Hepatobiliary Surgery, Dongyang People's Hospital, Dongyang, 322100, Zhejiang, China.
Abstract
BACKGROUND: This study was performed to compare the safety and effectiveness of early laparoscopic cholecystectomy (ELC) with delayed laparoscopic cholecystectomy (DLC) for acute cholecystitis (AC). METHODS: A systematic search was performed of PubMed, Embase, Web of Science, the Cochrane Central Register of Controlled Trials, and ClinicalTrials.gov from 1 August 1990 to 1 April 2018. Randomized controlled trials comparing ELC versus DLC were included. The primary outcome was bile duct injury (BDI) and bile leakage. The secondary outcomes were wound infection, total complications, conversion to open surgery, operation time, and total hospital stay. The statistical analysis was performed using Review Manager (RevMan) version 5.3 software (Cochrane Informatics and Knowledge Management Department). RESULTS: Fifteen RCTs were included. A meta-analysis showed no significant differences between ELC and DLC in terms of BDI (risk ratio [RR] 0.79; 95% confidence interval [CI] 0.23-2.79; p = 0.72) (in all subgroups of surgery: within 7, 4, and 3 days) (p = 0.22, 0.49, 0.49, respectively) or bile leakage (RR 2.05; 95% CI 0.98-4.31; p = 0.06). No significant differences were found in the rate of wound infection (RR 0.75; 95% CI 0.51-1.11; p = 0.15), total complications (RR 0.90; 95% CI 0.58-1.39; p = 0.63), or conversion to open surgery (RR 0.94; 95% CI 0.74-1.21; p = 0.64). There were no significant differences in the operation time between ELC and DLC (mean difference [MD] = 9.29 min; 95% CI - 0.41 to 18.98; p = 0.06), but ELC was associated with a longer surgery time within 7 days (MD = 16.49 min; 95% CI 2.10-30.88; p = 0.02). The pooled results showed that ELC was associated with a significantly shorter duration of hospital stay (MD = - 3.07 days; 95% CI - 3.98 to - 2.16; p < 0.00001), but with no significantly difference with postoperative hospital stay (MD = 0.45 days; 95% CI - 0.38 to 1.29; p = 0.29). CONCLUSION: ELC appears as safe and effective as DLC for acute cholecystitis within 7 days from presentation and may shorten the total hospital stay.
BACKGROUND: This study was performed to compare the safety and effectiveness of early laparoscopic cholecystectomy (ELC) with delayed laparoscopic cholecystectomy (DLC) for acute cholecystitis (AC). METHODS: A systematic search was performed of PubMed, Embase, Web of Science, the Cochrane Central Register of Controlled Trials, and ClinicalTrials.gov from 1 August 1990 to 1 April 2018. Randomized controlled trials comparing ELC versus DLC were included. The primary outcome was bile duct injury (BDI) and bile leakage. The secondary outcomes were wound infection, total complications, conversion to open surgery, operation time, and total hospital stay. The statistical analysis was performed using Review Manager (RevMan) version 5.3 software (Cochrane Informatics and Knowledge Management Department). RESULTS: Fifteen RCTs were included. A meta-analysis showed no significant differences between ELC and DLC in terms of BDI (risk ratio [RR] 0.79; 95% confidence interval [CI] 0.23-2.79; p = 0.72) (in all subgroups of surgery: within 7, 4, and 3 days) (p = 0.22, 0.49, 0.49, respectively) or bile leakage (RR 2.05; 95% CI 0.98-4.31; p = 0.06). No significant differences were found in the rate of wound infection (RR 0.75; 95% CI 0.51-1.11; p = 0.15), total complications (RR 0.90; 95% CI 0.58-1.39; p = 0.63), or conversion to open surgery (RR 0.94; 95% CI 0.74-1.21; p = 0.64). There were no significant differences in the operation time between ELC and DLC (mean difference [MD] = 9.29 min; 95% CI - 0.41 to 18.98; p = 0.06), but ELC was associated with a longer surgery time within 7 days (MD = 16.49 min; 95% CI 2.10-30.88; p = 0.02). The pooled results showed that ELC was associated with a significantly shorter duration of hospital stay (MD = - 3.07 days; 95% CI - 3.98 to - 2.16; p < 0.00001), but with no significantly difference with postoperative hospital stay (MD = 0.45 days; 95% CI - 0.38 to 1.29; p = 0.29). CONCLUSION: ELC appears as safe and effective as DLC for acute cholecystitis within 7 days from presentation and may shorten the total hospital stay.
Authors: Carsten N Gutt; Jens Encke; Jörg Köninger; Julian-Camill Harnoss; Kilian Weigand; Karl Kipfmüller; Oliver Schunter; Thorsten Götze; Markus T Golling; Markus Menges; Ernst Klar; Katharina Feilhauer; Wolfram G Zoller; Karsten Ridwelski; Sven Ackmann; Alexandra Baron; Michael R Schön; Helmut K Seitz; Dietmar Daniel; Wolfgang Stremmel; Markus W Büchler Journal: Ann Surg Date: 2013-09 Impact factor: 12.969
Authors: Syed Nabeel Zafar; Augustine Obirieze; Babawande Adesibikan; Edward E Cornwell; Terrence M Fullum; Daniel D Tran Journal: JAMA Surg Date: 2015-02 Impact factor: 14.766
Authors: Massimo Sartelli; Federico Coccolini; Yoram Kluger; Ervis Agastra; Fikri M Abu-Zidan; Ashraf El Sayed Abbas; Luca Ansaloni; Abdulrashid Kayode Adesunkanmi; Boyko Atanasov; Goran Augustin; Miklosh Bala; Oussama Baraket; Suman Baral; Walter L Biffl; Marja A Boermeester; Marco Ceresoli; Elisabetta Cerutti; Osvaldo Chiara; Enrico Cicuttin; Massimo Chiarugi; Raul Coimbra; Elif Colak; Daniela Corsi; Francesco Cortese; Yunfeng Cui; Dimitris Damaskos; Nicola De' Angelis; Samir Delibegovic; Zaza Demetrashvili; Belinda De Simone; Stijn W de Jonge; Sameer Dhingra; Stefano Di Bella; Francesco Di Marzo; Salomone Di Saverio; Agron Dogjani; Therese M Duane; Mushira Abdulaziz Enani; Paola Fugazzola; Joseph M Galante; Mahir Gachabayov; Wagih Ghnnam; George Gkiokas; Carlos Augusto Gomes; Ewen A Griffiths; Timothy C Hardcastle; Andreas Hecker; Torsten Herzog; Syed Mohammad Umar Kabir; Aleksandar Karamarkovic; Vladimir Khokha; Peter K Kim; Jae Il Kim; Andrew W Kirkpatrick; Victor Kong; Renol M Koshy; Igor A Kryvoruchko; Kenji Inaba; Arda Isik; Katia Iskandar; Rao Ivatury; Francesco M Labricciosa; Yeong Yeh Lee; Ari Leppäniemi; Andrey Litvin; Davide Luppi; Gustavo M Machain; Ronald V Maier; Athanasios Marinis; Cristina Marmorale; Sanjay Marwah; Cristian Mesina; Ernest E Moore; Frederick A Moore; Ionut Negoi; Iyiade Olaoye; Carlos A Ordoñez; Mouaqit Ouadii; Andrew B Peitzman; Gennaro Perrone; Manos Pikoulis; Tadeja Pintar; Giuseppe Pipitone; Mauro Podda; Kemal Raşa; Julival Ribeiro; Gabriel Rodrigues; Ines Rubio-Perez; Ibrahima Sall; Norio Sato; Robert G Sawyer; Helmut Segovia Lohse; Gabriele Sganga; Vishal G Shelat; Ian Stephens; Michael Sugrue; Antonio Tarasconi; Joel Noutakdie Tochie; Matti Tolonen; Gia Tomadze; Jan Ulrych; Andras Vereczkei; Bruno Viaggi; Chiara Gurioli; Claudio Casella; Leonardo Pagani; Gian Luca Baiocchi; Fausto Catena Journal: World J Emerg Surg Date: 2021-09-25 Impact factor: 5.469