Alejandro Quiroga-Garza1, Neri A Alvarez-Villalobos2, Hermilo J Angeles-Mar3, Mariano Garcia-Campa4, Milton A Muñoz-Leija3, Yolanda Salinas-Alvarez3, Rodrigo E Elizondo-Omaña5, Santos Guzmán-López6. 1. Universidad Autónoma de Nuevo León, School of Medicine, Human Anatomy Department, Mexico; Instituto Mexicano Del Seguro Social, Delegación Nuevo Leon, Monterrey, Mexico. 2. Instituto Mexicano Del Seguro Social, Delegación Nuevo Leon, Monterrey, Mexico; Universidad Autónoma de Nuevo León, School of Medicine, Plataforma INVEST Medicina UANL-KER Unit Mayo Clinic (KER Unit México), Mexico. 3. Universidad Autónoma de Nuevo León, School of Medicine, Human Anatomy Department, Mexico. 4. Universidad Autónoma de Nuevo León, School of Medicine, Plataforma INVEST Medicina UANL-KER Unit Mayo Clinic (KER Unit México), Mexico. 5. Universidad Autónoma de Nuevo León, School of Medicine, Human Anatomy Department, Mexico. Electronic address: rod_omana@yahoo.com. 6. Universidad Autónoma de Nuevo León, School of Medicine, Human Anatomy Department, Mexico. Electronic address: dr.santos.anato@gmail.com.
Abstract
BACKGROUND: The optimal management of localized gallbladder perforation (Neimeier type II) has yet to be defined. The aim of this systematic review was to identify factors associated with improved patient outcomes. METHODS: Systematic review of studies that described the management of Neimeier type II perforation, reported complications of the first intervention, necessity of added interventions, resolution of the pathology, and days of hospital stay were included. The search strategy was conducted in EMBASE, Mayo Journals, MEDLINE, SCOPUS, and Web of Science (December 2020) RESULTS: A total of 122 patients (53% male) from case reports, series, and cohorts were included for analysis. In total 56 (46%) and 44 (36%)patients were treated with open and laparoscopic cholecystectomy respectively. Overall risk of bias was moderate. The need for another intervention was higher in the laparoscopic group (5 vs 17, p=<0.001) as well as prevalence of complications (4 vs 16, p=<0.001), but lower for days of hospital stay (median days 5. vs 15, p = 0.008) against open cholecystectomy. Preoperative percutaneous catheter drainage did not influence outcome. CONCLUSION: Open cholecystectomy has a lower need for further surgical procedures and postoperative complications, but a longer hospital stay. These outcomes did not vary with preoperative percutaneous drainage. The effect of timing of cholecystectomy did not influence the outcomes.
BACKGROUND: The optimal management of localized gallbladder perforation (Neimeier type II) has yet to be defined. The aim of this systematic review was to identify factors associated with improved patient outcomes. METHODS: Systematic review of studies that described the management of Neimeier type II perforation, reported complications of the first intervention, necessity of added interventions, resolution of the pathology, and days of hospital stay were included. The search strategy was conducted in EMBASE, Mayo Journals, MEDLINE, SCOPUS, and Web of Science (December 2020) RESULTS: A total of 122 patients (53% male) from case reports, series, and cohorts were included for analysis. In total 56 (46%) and 44 (36%)patients were treated with open and laparoscopic cholecystectomy respectively. Overall risk of bias was moderate. The need for another intervention was higher in the laparoscopic group (5 vs 17, p=<0.001) as well as prevalence of complications (4 vs 16, p=<0.001), but lower for days of hospital stay (median days 5. vs 15, p = 0.008) against open cholecystectomy. Preoperative percutaneous catheter drainage did not influence outcome. CONCLUSION: Open cholecystectomy has a lower need for further surgical procedures and postoperative complications, but a longer hospital stay. These outcomes did not vary with preoperative percutaneous drainage. The effect of timing of cholecystectomy did not influence the outcomes.
Authors: Luis Rodrigo Gómez-Álvarez; Tomás Benavides-Zavala; Levi Eliezer Delgado-García; José Rafael Fernández-Treviño; Manuel Enrique de la O-Escamilla; Alberto Gómez-Orozco; Gerardo Muñoz-Maldonado Journal: J Surg Case Rep Date: 2022-02-18