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Meta-analysis comparing early versus delayed laparoscopic cholecystectomy for acute cholecystitis
1First College of Clinical Medicine, Chongqing Medical University, Chongqing, China.
The British Journal of Surgery
|August 13, 2015
Summary
Early laparoscopic cholecystectomy (ELC) for acute cholecystitis is as safe and effective as delayed surgery (DLC). ELC offers lower costs, fewer missed work days, and improved patient satisfaction.
Area of Science:
- Gastroenterology and Hepatology
- Surgical Innovation
- Evidence-Based Medicine
Background:
- Previous comparative studies on early laparoscopic cholecystectomy (ELC) versus delayed laparoscopic cholecystectomy (DLC) for acute cholecystitis were limited.
- A comprehensive meta-analysis was required to evaluate ELC and DLC concerning cost-effectiveness, quality of life, safety, and overall effectiveness.
Purpose of the Study:
- To conduct a meta-analysis comparing early laparoscopic cholecystectomy (ELC) with delayed laparoscopic cholecystectomy (DLC) for acute cholecystitis.
- To assess the cost-effectiveness, quality of life, safety, and effectiveness of ELC versus DLC.
Main Methods:
- A systematic literature search was performed across PubMed, Embase, the Cochrane Library, and Web of Science.
- Included randomized clinical trials (RCTs) comparing ELC (within 7 days of symptom onset) with DLC (at least 1 week after symptom resolution) for acute cholecystitis.
Main Results:
- Sixteen studies involving 1625 patients were analyzed.
- ELC demonstrated lower hospital costs, reduced work days lost, and higher patient satisfaction compared to DLC.
- ELC also showed a lower risk of wound infection and shorter hospital stays, with no significant differences in mortality or major complications.
Conclusions:
- Early laparoscopic cholecystectomy (ELC) is a safe and effective treatment option for acute cholecystitis, comparable to delayed laparoscopic cholecystectomy (DLC).
- ELC may lead to significant economic benefits through reduced hospital costs and fewer work days lost.
- Patients undergoing ELC reported greater satisfaction and improved quality of life.
