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Same-admission versus delayed cholecystectomy for mild acute biliary pancreatitis: a systematic review and meta-analysis
BACKGROUND: The timing of laparoscopic cholecystectomy (LC) performed after the mild acute biliary pancreatitis (MABP) is still controversial. We conducted a review to compare same-admission laparoscopic cholecystectomy (SA-LC) and delayed laparoscopic cholecystectomy (DLC) after mild acute biliary...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2018
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6263067/ https://www.ncbi.nlm.nih.gov/pubmed/30486807 http://dx.doi.org/10.1186/s12893-018-0445-9 |
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author | Lyu, Yun-Xiao Cheng, Yun-Xiao Jin, Hang-Fei Jin, Xin Cheng, Bin Lu, Dian |
author_facet | Lyu, Yun-Xiao Cheng, Yun-Xiao Jin, Hang-Fei Jin, Xin Cheng, Bin Lu, Dian |
author_sort | Lyu, Yun-Xiao |
collection | PubMed |
description | BACKGROUND: The timing of laparoscopic cholecystectomy (LC) performed after the mild acute biliary pancreatitis (MABP) is still controversial. We conducted a review to compare same-admission laparoscopic cholecystectomy (SA-LC) and delayed laparoscopic cholecystectomy (DLC) after mild acute biliary pancreatitis (MABP). METHODS: We systematically searched several databases (PubMed, EMBASE, Web of Science, and the Cochrane Library) for relevant trials published from 1 January 1992 to 1 June 2018. Human prospective or retrospective studies that compared SA-LC and DLC after MABP were included. The measured outcomes were the rate of conversion to open cholecystectomy (COC), rate of postoperative complications, rate of biliary-related complications, operative time (OT), and length of stay (LOS). The meta-analysis was performed using Review Manager 5.3 software (The Cochrane Collaboration, Oxford, United Kingdom). RESULTS: This meta-analysis involved 1833 patients from 4 randomized controlled trials and 7 retrospective studies. No significant differences were found in the rate of COC (risk ratio [RR] = 1.24; 95% confidence interval [CI], 0.78–1.97; p = 0.36), rate of postoperative complications (RR = 1.06; 95% CI, 0.67–1.69; p = 0.80), rate of biliary-related complications (RR = 1.28; 95% CI, 0.42–3.86; p = 0.66), or OT (RR = 1.57; 95% CI, − 1.58–4.72; p = 0.33) between the SA-LC and DLC groups. The LOS was significantly longer in the DLC group (RR = − 2.08; 95% CI, − 3.17 to − 0.99; p = 0.0002). Unexpectedly, the subgroup analysis showed no significant difference in LOS according to the Atlanta classification (RR = − 0.40; 95% CI, − 0.80–0.01; p = 0.05). The gallstone-related complications during the waiting time in the DLC group included gall colic, recurrent pancreatitis, acute cholecystitis, jaundice, and acute cholangitis (total, 25.39%). CONCLUSION: This study confirms the safety of SA-LC, which could shorten the LOS. However, the study findings have a number of important implications for future practice. |
format | Online Article Text |
id | pubmed-6263067 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-62630672018-12-05 Same-admission versus delayed cholecystectomy for mild acute biliary pancreatitis: a systematic review and meta-analysis Lyu, Yun-Xiao Cheng, Yun-Xiao Jin, Hang-Fei Jin, Xin Cheng, Bin Lu, Dian BMC Surg Research Article BACKGROUND: The timing of laparoscopic cholecystectomy (LC) performed after the mild acute biliary pancreatitis (MABP) is still controversial. We conducted a review to compare same-admission laparoscopic cholecystectomy (SA-LC) and delayed laparoscopic cholecystectomy (DLC) after mild acute biliary pancreatitis (MABP). METHODS: We systematically searched several databases (PubMed, EMBASE, Web of Science, and the Cochrane Library) for relevant trials published from 1 January 1992 to 1 June 2018. Human prospective or retrospective studies that compared SA-LC and DLC after MABP were included. The measured outcomes were the rate of conversion to open cholecystectomy (COC), rate of postoperative complications, rate of biliary-related complications, operative time (OT), and length of stay (LOS). The meta-analysis was performed using Review Manager 5.3 software (The Cochrane Collaboration, Oxford, United Kingdom). RESULTS: This meta-analysis involved 1833 patients from 4 randomized controlled trials and 7 retrospective studies. No significant differences were found in the rate of COC (risk ratio [RR] = 1.24; 95% confidence interval [CI], 0.78–1.97; p = 0.36), rate of postoperative complications (RR = 1.06; 95% CI, 0.67–1.69; p = 0.80), rate of biliary-related complications (RR = 1.28; 95% CI, 0.42–3.86; p = 0.66), or OT (RR = 1.57; 95% CI, − 1.58–4.72; p = 0.33) between the SA-LC and DLC groups. The LOS was significantly longer in the DLC group (RR = − 2.08; 95% CI, − 3.17 to − 0.99; p = 0.0002). Unexpectedly, the subgroup analysis showed no significant difference in LOS according to the Atlanta classification (RR = − 0.40; 95% CI, − 0.80–0.01; p = 0.05). The gallstone-related complications during the waiting time in the DLC group included gall colic, recurrent pancreatitis, acute cholecystitis, jaundice, and acute cholangitis (total, 25.39%). CONCLUSION: This study confirms the safety of SA-LC, which could shorten the LOS. However, the study findings have a number of important implications for future practice. BioMed Central 2018-11-29 /pmc/articles/PMC6263067/ /pubmed/30486807 http://dx.doi.org/10.1186/s12893-018-0445-9 Text en © The Author(s). 2018 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Research Article Lyu, Yun-Xiao Cheng, Yun-Xiao Jin, Hang-Fei Jin, Xin Cheng, Bin Lu, Dian Same-admission versus delayed cholecystectomy for mild acute biliary pancreatitis: a systematic review and meta-analysis |
title | Same-admission versus delayed cholecystectomy for mild acute biliary pancreatitis: a systematic review and meta-analysis |
title_full | Same-admission versus delayed cholecystectomy for mild acute biliary pancreatitis: a systematic review and meta-analysis |
title_fullStr | Same-admission versus delayed cholecystectomy for mild acute biliary pancreatitis: a systematic review and meta-analysis |
title_full_unstemmed | Same-admission versus delayed cholecystectomy for mild acute biliary pancreatitis: a systematic review and meta-analysis |
title_short | Same-admission versus delayed cholecystectomy for mild acute biliary pancreatitis: a systematic review and meta-analysis |
title_sort | same-admission versus delayed cholecystectomy for mild acute biliary pancreatitis: a systematic review and meta-analysis |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6263067/ https://www.ncbi.nlm.nih.gov/pubmed/30486807 http://dx.doi.org/10.1186/s12893-018-0445-9 |
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