Background: The optimal timing of laparoscopic cholecystectomy (LC) in patients with mild acute gallstone pancreatitis (MAGP) is controversial. The aim of this study was to systematically evaluate and compare the safety and efficacy of early laparoscopic cholecystectomy (ELC) and delayed laparoscopic cholecystectomy (DLC) in patients with MAGP.
Methods: A strict search was conducted of the electronic databases, including PubMed, MEDLINE Embase, the ISI Web of Science, and Cochrane Library for all relevant English literature and RevMan5.3 software for statistical analysis was used.
Results: A total of 19 studies comprising 2639 patients were included. There was no significant difference in intraoperative complications [risk ratio (RR) = 1.46; 95% confidence interval (CI) = 0.88-2.41; P = .14)], postoperative complications (RR = 0.81; 95% CI = 0.58-1.14; P = .23), rate of conversion to open cholecystectomy (RR = 1.00; 95% CI = 0.75-1.33; P = .99), operative time (MD = 1.60; 95% CI = -1.36-4.56; P = .29), and rate of readmission (RR = 0.63; 95% CI = 0.19-2.10; P = .45) between the ELC and DLC groups. However, the ELC group was significantly correlated with lower length of hospital stay (MD = -2.01; 95% CI = -3.15 to -0.87; P = .0006), fewer gallstone-related events rates (RR = 0.17; 95% CI = 0.07-0.44; P = .0003), and lower endoscopic retrograde cholangiopancreatography (ERCP) usage (RR = 0.83; 95% CI = 0.71-0.97; P = .02) compared with the DLC group.
Conclusion: Early laparoscopic cholecystectomy is safe and effective for patients with MAGP, but the indications and contraindications must be strictly controlled.
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http://dx.doi.org/10.1097/MD.0000000000017429 | DOI Listing |
Langenbecks Arch Surg
January 2025
Department of General Surgery, Hangzhou Hospital of Traditional Chinese Medicine, No. 453 Ti-Yu-Chang Road, Hangzhou, Zhejiang, 310007, People's Republic of China.
Objective: To study the effect of transversus abdominis plane (TAP) block under direct vision with acupoint injection on the rapid recovery of patients after laparoscopic cholecystectomy.
Methods: Ninety-three patients undergoing laparoscopic cholecystectomy at Hangzhou Hospital of Traditional Chinese Medicine from January 2023 to December 2023 were selected and divided into control, TAP block under direct vision (TAP-DV), and TAP-DV with acupoint injection (TAP-DVA) groups using a random number table method. Postoperative VAS, Ramsay score, IL-6, CRP, and postoperative rehabilitation indices were compared among the three groups.
BMC Surg
January 2025
Health Sciences Faculty, Gedik University, Istanbul, Turkey.
Background: In this study, we aimed to investigate whether ursodeoxycholic acid (UDCA) would reduce the necessity of cholecystectomy in patients diagnosed with asymptomatic gallstones after laparoscopic sleeve gastrectomy (LSG) and in patients diagnosed with asymptomatic gallstones before LSG.
Methods: Between July 2020 and November 2022, at least 2-year follow-ups of patients who underwent LSG for obesity were retrospectively analyzed. Patients with pre-existing asymptomatic gallstones during preoperative evaluation, those with UDCA treatment (group 1), and observation group (group 2).
HPB (Oxford)
January 2025
Department of Surgical Gastroenterology, All India Institute of Medical Sciences, Patna, India.
Background: Our study aimed to compare the clinical presentation and outcomes of post-cholecystectomy bile duct injuries (BDI) with and without arterial injuries.
Methods: A prospective analysis of 123 patients with post-cholecystectomy BDI between July 2018 and January 2022 was performed. Multivariate logistic regression analysis was used to assess the impact of vascular injuries on perioperative complications and long-term outcomes after delayed repair.
Am J Transl Res
December 2024
Department of Anesthesiology, Xi'an Central Hospital No. 161, Xiwu Road, Xincheng District, Xi'an 710003, Shaanxi, China.
Objective: To evaluate the effects of preemptive hydromorphone analgesia on postoperative delirium and stress response in patients undergoing laparoscopic cholecystectomy.
Methods: A retrospective cohort study was conducted, including 167 patients who underwent laparoscopic cholecystectomy at Xi'an Central Hospital between June 2021 and November 2023. Patients were categorized into an observation group (n=87) receiving preemptive hydromorphone hydrochloride analgesia and a control group (n=80) without preemptive analgesia.
Eur J Trauma Emerg Surg
January 2025
Department of Surgical Science, University of Cagliari, Cagliari, Italy.
Background: The current standard of care for mild acute biliary pancreatitis (MABP) involves early laparoscopic cholecystectomy (ELC) to reduce the risk of recurrence. The MANCTRA-1 project revealed a knowledge-to-action gap and higher recurrence rates in patients admitted to medical wards, attributable to fewer ELCs being performed. The project estimated a 35% to 70% probability of narrowing this gap by 2025.
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