Abstract
Background: In many countries laparoscopic cholecystectomy for acute cholecystitis ismainly performed after the acute episode has settled because of the anticipated increased risk of morbidity and higher conversion rate from laparoscopic to open cholecystectomy. Methods: A systematic review was performed with meta-analysis of randomized clinical trials of early laparoscopic cholecystectomy (ELC; performed within 1 week of onset of symptoms) versus delayed laparoscopic cholecystectomy (performed at least 6 weeks after symptoms settled) for acute cholecystitis. Trials were identified from The Cochrane Library trials register, Medline, Embase, Science Citation Index Expanded and reference lists. Risk ratio (RR) or mean difference was calculated with 95 per cent confidence intervals (c.i.) based on intention-to-treat analysis. Results: Five trials with 451 patients were included. There was no significant difference between the two groups in terms of bile duct injury (RR 0.64 (95 per cent c.i. 0.15 to 2.65)) or conversion to open cholecystectomy (RR 0.88 (95 per cent c.i. 0.62 to 1.25)). The total hospital stay was shorter by 4 days for ELC (mean difference -4.12 (95 per cent c.i. -5.22 to -3.03) days). Conclusion: ELC during acute cholecystitis appears safe and shortens the total hospital stay.
| Original language | English |
|---|---|
| Journal | British Journal of Surgery |
| Volume | 97 |
| Issue number | 2 |
| Pages (from-to) | 141-50 |
| Number of pages | 9 |
| ISSN | 0007-1323 |
| DOIs | |
| Publication status | Published - Feb 2010 |