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The ideal timing for ELC continues to be debatable in patients with acute calculator cholecystitis (ACC). This study was planned to identify the impact of different ELC timing in ACC on surgical outcomes in terms of safety and efficacy
This multicentric analysis involved of successive patients with ACC ELC between April 2018 and March 2020. Patients were divided into three groups according to the timing of the surgery: from the onset of symptoms within the first 3 days (group 1), between 4 and 7 days (group 2), and beyond 7 days (group 3). The primary outcome was the incidence of postoperative complications The secondary outcomes were conversion rate, blood loss, operative times, operational difficulty, the cost-benefit relationship, postoperative stay with each treatment line.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| from the onset of symptoms within the first 3 days (group 1) | Active Comparator | ELC for ACC from the onset of symptoms within the first 3 days (group 1) |
|
| from the onset of symptoms within the 4-7 days | Active Comparator | ELC for ACC from the onset of symptoms within the4-7 days (group II) |
|
| from the onset of symptoms beyond 7 days | Active Comparator | ELC for ACC from the onset of symptoms beyond 7 days (group III) |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| from the onset of symptoms within the first 3 days | Procedure | ELC within 3 days of onset of ACC |
|
| Measure | Description | Time Frame |
|---|---|---|
| the incidence of postoperative morbidity | the incidence of postoperative morbidity during the 30th day of postoperative procedure | 30 DAYS |
| Measure | Description | Time Frame |
|---|---|---|
| conversion rate | conversion rate to open cholecystectomy | INTRAOPERATIVE |
| blood loss | blood loss | intraoperative |
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Inclusion Criteria:
ACC patients who underwent early LC
Exclusion Criteria:
Pregnancy, Acalculous cholecystitis, CBDS, Ascending cholangitis, Pancreatitis, ASA score 4, Patients scheduled for DLC with failed medical treatment.
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| Name | Affiliation | Role |
|---|---|---|
| Ayman E Nakeeb | Mansoura University, Gastrointestinal Surgery Center | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Mohamed Attea | Al Mansurah | 356111 | Egypt |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 32425482 | Result | El Zanati H, Nassar AHM, Zino S, Katbeh T, Ng HJ, Abdellatif A. Gall Bladder Empyema: Early Cholecystectomy during the Index Admission Improves Outcomes. JSLS. 2020 Apr-Jun;24(2):e2020.00015. doi: 10.4293/JSLS.2020.00015. | |
| 31388885 | Result | Mora-Guzman I, Di Martino M, Gancedo Quintana A, Martin-Perez E. Laparoscopic Cholecystectomy for Acute Cholecystitis: Is the Surgery Still Safe beyond the 7-Day Barrier? J Gastrointest Surg. 2020 Aug;24(8):1827-1832. doi: 10.1007/s11605-019-04335-5. Epub 2019 Aug 6. |
| Label | URL |
|---|---|
| Mansoura university | View source |
| ID | Type | URL | Comment |
|---|---|---|---|
| Ayman El Nakeeb | Study Protocol | View IPD |
plan to make individual participant data (
6 months
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| ID | Term |
|---|---|
| D041881 | Cholecystitis, Acute |
| ID | Term |
|---|---|
| D002764 | Cholecystitis |
| D005705 | Gallbladder Diseases |
| D001660 | Biliary Tract Diseases |
| D004066 | Digestive System Diseases |
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Patients with ACC were divided into three groups according to the timing of the surgery: from the onset of symptoms within the first 3 days (group 1), between 4 and 7 days (group 2) and beyond 7 days (group 3).
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Patients were divided into three groups according to the timing of the surgery: from the onset of symptoms within the first 3 days (group 1), between 4 and 7 days (group 2) and beyond 7 days (group 3).
| : from the onset of symptoms within the 4-7 days | Procedure | ELC 4-7days of onset of ACC |
|
|
| from the onset of symptoms beyond 7 days | Procedure | ELC after 7days of onset of ACC |
|
|
| hospital stay | overall hospital stay | 30 days |
| 30354853 | Result | Brunee L, Hauters P, Closset J, Fromont G, Puia-Negelescu S; Club Coelio. Assessment of the optimal timing for early laparoscopic cholecystectomy in acute cholecystitis: a prospective study of the Club Coelio. Acta Chir Belg. 2019 Oct;119(5):309-315. doi: 10.1080/00015458.2018.1529344. Epub 2018 Oct 25. |
| 28569137 | Result | Inoue K, Ueno T, Nishina O, Douchi D, Shima K, Goto S, Takahashi M, Shibata C, Naito H. Optimal timing of cholecystectomy after percutaneous gallbladder drainage for severe cholecystitis. BMC Gastroenterol. 2017 May 31;17(1):71. doi: 10.1186/s12876-017-0631-8. |
| 27785732 | Result | Onoe S, Kaneoka Y, Maeda A, Takayama Y, Fukami Y. Feasibility of laparoscopic cholecystectomy for acute cholecystitis beyond 72 h of symptom onset. Updates Surg. 2016 Dec;68(4):377-383. doi: 10.1007/s13304-016-0409-5. Epub 2016 Oct 26. |
| 26218858 | Result | Menahem B, Mulliri A, Fohlen A, Guittet L, Alves A, Lubrano J. Delayed laparoscopic cholecystectomy increases the total hospital stay compared to an early laparoscopic cholecystectomy after acute cholecystitis: an updated meta-analysis of randomized controlled trials. HPB (Oxford). 2015 Oct;17(10):857-62. doi: 10.1111/hpb.12449. Epub 2015 Jul 27. |