Early versus delayed laparoscopic cholecystectomy for acute cholecystitis: an up-to-date meta-analysis of randomized controlled trials

Surgical Endoscopy
Yunxiao LyuLiang Chen

Abstract

This study was performed to compare the safety and effectiveness of early laparoscopic cholecystectomy (ELC) with delayed laparoscopic cholecystectomy (DLC) for acute cholecystitis (AC). 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). 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...Continue Reading

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Jul 13, 2019·Langenbeck's Archives of Surgery·Kristian Kiim JensenLinda Bardram
Mar 27, 2021·World Journal of Emergency Surgery : WJES·Giuseppe BorzellinoYoram Kluger
Jun 11, 2021·Langenbeck's Archives of Surgery·Nina Sonne BundgaardAnders Peter Skovsen

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