Early laparoscopic cholecystectomy reduces hospital stay in mild gallstone pancreatitis. A randomized controlled trial
| Autor: | Jorge Muñoz, Cristian Astudillo, Waldo Martínez, Marco Salazar, Felipe Catán, Sebastián Uribe-Echevarría, Boris Marinkovic, Francisco Riquelme, Mario Uribe, Felipe Puelma, Andrea Canals |
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| Rok vydání: | 2019 |
| Předmět: |
Adult
Male medicine.medical_specialty medicine.medical_treatment Gallstones Patient Readmission Severity of Illness Index law.invention Time-to-Treatment 03 medical and health sciences Young Adult 0302 clinical medicine Postoperative Complications Randomized controlled trial law medicine Humans In patient Laparoscopic cholecystectomy Aged Cholangiopancreatography Endoscopic Retrograde Hepatology Common bile duct business.industry Gastroenterology Length of Stay Middle Aged Interim analysis medicine.disease Surgery medicine.anatomical_structure Choledocholithiasis Treatment Outcome Cholecystectomy Laparoscopic Pancreatitis 030220 oncology & carcinogenesis 030211 gastroenterology & hepatology Cholecystectomy Female business Hospital stay |
| Zdroj: | HPB : the official journal of the International Hepato Pancreato Biliary Association. 22(1) |
| ISSN: | 1477-2574 |
| Popis: | Background Two strategies for same-admission cholecystectomy in mild gallstone pancreatitis (MGP) exist: early surgery (within 48–72 h from admission) and delayed surgery until resolution of symptoms and normalization of pancreatic tests. Methods This was a single-center, open-label RCT. Patients with MGP according to revised Atlanta classification-2012 and SIRS criteria were randomly assigned to early laparoscopic cholecystectomy (E-LC) within 72 h from admission or delayed laparoscopic cholecystectomy (D-LC). Laparoscopic-endoscopic rendezvous was performed when common bile duct stones were found at systematic intraoperative cholangiography. The primary outcome was length of stay (LOS), and the secondary outcomes were complications at 90 days, need for ERCP/choledocolithiasis, conversion, and re-admission. One year of follow-up was carried-on. Results At interim analysis, 52 patients were randomized (26 E-LC, 26 D-LC). E-LC versus D-LC was associated with a significantly shorter LOS (median 58 versus 167 h; P = 0.001). There were no differences in ERCP necessity for choledocolithiasis between the two approaches (E-LC 26.9% versus D-LC 23.1%, P = 1.00). No differences in postoperative complications were found. Conclusions E-LC approach in patients with MGP significantly reduced LOS and was not associated with clinically relevant postoperative complications. Trial registration clinicaltrials.gov ( NCT02590978 ). |
| Databáze: | OpenAIRE |
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