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Uncomplicated acute cholecystitis: early or delayed laparoscopic cholecystectomy?
Ajith Sankarankutty1, Luis Teodoro da Luz, Tercio De Campos
1Department of Surgery and Anatomy, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP,Brazil.
Revista Do Colegio Brasileiro De Cirurgioes
|November 24, 2012
Summary
Early laparoscopic cholecystectomy within one week of symptom onset is safe and shortens hospital stays for acute gallbladder disease. Further cost-effectiveness analysis is recommended at the hospital level.
Area of Science:
- Surgical Gastroenterology
- Health Services Research
Background:
- Early laparoscopic cholecystectomy (LC) is suggested as safe and feasible for acute gallbladder disease.
- Current surgical practice shows limited adoption of early LC, with timing and cost-effectiveness debated.
Purpose of the Study:
- To critically appraise recent evidence on the timing and cost-effectiveness of LC for uncomplicated acute cholecystitis.
- To provide evidence-based recommendations for clinical practice.
Main Methods:
- Critical appraisal of recently published literature.
- Review of small trials with potential biases and limited cost-utility analyses.
Main Results:
- Early LC (within one week of symptom onset) appears safe and reduces hospital stay.
- Evidence for cost-effectiveness is limited due to scarcity of well-designed, large-scale studies.
Conclusions:
- Early LC should be considered the first-line treatment within one week of symptom onset.
- Hospital-level evaluation of early LC cost-effectiveness is necessary, considering local resources and personnel.
