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Article: Early versus delayed-interval laparoscopic cholecystectomy for acute cholecystitis: A metaanalysis

TitleEarly versus delayed-interval laparoscopic cholecystectomy for acute cholecystitis: A metaanalysis
Authors
KeywordsAcute cholecystitis
Laparoscopic cholecystectomy
Metaanalysis
Systematic review
Issue Date2006
PublisherSpringer New York LLC. The Journal's web site is located at http://link.springer-ny.com/link/service/journals/00464/
Citation
Surgical Endoscopy And Other Interventional Techniques, 2006, v. 20 n. 1, p. 82-87 How to Cite?
AbstractBackground: Early laparoscopic cholecystectomy has been advocated for the management of acute cholecystitis, but little evidence exists to support the superiority of this approach over delayed-interval operation. The current systematic review was undertaken to compare the outcomes and efficacy between early and delayed-interval laparoscopic cholecystectomy for acute cholecystitis in an evidence-based approach using metaanalytical techniques. Methods: A search of electronic databases, including MEDLINE and EMBASE, was conducted to identify relevant articles published between January 1988 and June 2004. Only randomized or quasi-randomized prospective clinical trials in the English language comparing the outcomes of early and delayed-interval laparoscopic cholecystectomy for acute cholecystitis were recruited. Both qualitative and quantitative statistical analyses were performed. The effect size of outcome parameters was estimated by odds ratio or weighted mean difference where feasible and appropriate. Results: A total of four clinical trials comprising 504 patients met the inclusion criteria. Failure of conservative treatment requiring emergency cholecystectomy occurred for 43 patients (23%) in the delayed group. Metaanalyses demonstrated a significantly shortened total length of hospital stay in the early group (weighted mean difference, -1.12; 95% confidence interval [CI], -1.42 to -0.99; p < 0.001). Pooled estimates did not show any significant differences between the two approaches in terms of operation time, conversion rate, overall complication rate, incidence of bile leakage, and intraabdominal collection. Conclusions: The safety and efficacy of early and delayed-interval laparoscopic cholecystectomy for acute cholecystitis were comparable. Because evidence suggested that early laparoscopic cholecystectomy reduced the total length of hospital stay and the risk of readmissions attributable to recurrent acute cholecystitis, it is therefore a more cost-effective approach for the management of acute cholecystitis. © Springer Science+Business Media, Inc. 2005.
Persistent Identifierhttp://hdl.handle.net/10722/84348
ISSN
2015 Impact Factor: 3.54
2015 SCImago Journal Rankings: 1.695
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorLau, Hen_HK
dc.contributor.authorLo, CYen_HK
dc.contributor.authorPatil, NGen_HK
dc.contributor.authorYuen, WKen_HK
dc.date.accessioned2010-09-06T08:51:53Z-
dc.date.available2010-09-06T08:51:53Z-
dc.date.issued2006en_HK
dc.identifier.citationSurgical Endoscopy And Other Interventional Techniques, 2006, v. 20 n. 1, p. 82-87en_HK
dc.identifier.issn0930-2794en_HK
dc.identifier.urihttp://hdl.handle.net/10722/84348-
dc.description.abstractBackground: Early laparoscopic cholecystectomy has been advocated for the management of acute cholecystitis, but little evidence exists to support the superiority of this approach over delayed-interval operation. The current systematic review was undertaken to compare the outcomes and efficacy between early and delayed-interval laparoscopic cholecystectomy for acute cholecystitis in an evidence-based approach using metaanalytical techniques. Methods: A search of electronic databases, including MEDLINE and EMBASE, was conducted to identify relevant articles published between January 1988 and June 2004. Only randomized or quasi-randomized prospective clinical trials in the English language comparing the outcomes of early and delayed-interval laparoscopic cholecystectomy for acute cholecystitis were recruited. Both qualitative and quantitative statistical analyses were performed. The effect size of outcome parameters was estimated by odds ratio or weighted mean difference where feasible and appropriate. Results: A total of four clinical trials comprising 504 patients met the inclusion criteria. Failure of conservative treatment requiring emergency cholecystectomy occurred for 43 patients (23%) in the delayed group. Metaanalyses demonstrated a significantly shortened total length of hospital stay in the early group (weighted mean difference, -1.12; 95% confidence interval [CI], -1.42 to -0.99; p < 0.001). Pooled estimates did not show any significant differences between the two approaches in terms of operation time, conversion rate, overall complication rate, incidence of bile leakage, and intraabdominal collection. Conclusions: The safety and efficacy of early and delayed-interval laparoscopic cholecystectomy for acute cholecystitis were comparable. Because evidence suggested that early laparoscopic cholecystectomy reduced the total length of hospital stay and the risk of readmissions attributable to recurrent acute cholecystitis, it is therefore a more cost-effective approach for the management of acute cholecystitis. © Springer Science+Business Media, Inc. 2005.en_HK
dc.languageengen_HK
dc.publisherSpringer New York LLC. The Journal's web site is located at http://link.springer-ny.com/link/service/journals/00464/en_HK
dc.relation.ispartofSurgical Endoscopy and Other Interventional Techniquesen_HK
dc.subjectAcute cholecystitisen_HK
dc.subjectLaparoscopic cholecystectomyen_HK
dc.subjectMetaanalysisen_HK
dc.subjectSystematic reviewen_HK
dc.titleEarly versus delayed-interval laparoscopic cholecystectomy for acute cholecystitis: A metaanalysisen_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=0930-2794&volume=20&issue=1&spage=82&epage=87&date=2006&atitle=Early+versus+delayed-interval+laparoscopic+cholecystectomy+for+acute+cholecystitis:+a+metaanalysisen_HK
dc.identifier.emailPatil, NG: ngpatil@hkucc.hku.hken_HK
dc.identifier.authorityPatil, NG=rp00388en_HK
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1007/s00464-005-0100-2en_HK
dc.identifier.pmid16247580en_HK
dc.identifier.scopuseid_2-s2.0-30744475474en_HK
dc.identifier.hkuros117633en_HK
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-30744475474&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume20en_HK
dc.identifier.issue1en_HK
dc.identifier.spage82en_HK
dc.identifier.epage87en_HK
dc.identifier.isiWOS:000234485400012-
dc.publisher.placeUnited Statesen_HK
dc.identifier.scopusauthoridLau, H=7201497812en_HK
dc.identifier.scopusauthoridLo, CY=36151700700en_HK
dc.identifier.scopusauthoridPatil, NG=7103152514en_HK
dc.identifier.scopusauthoridYuen, WK=7102761292en_HK

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