Evidence map›Paper›PMID 29380173›Full record

ArticleDigestive diseases and sciences2018

Surgery Reduces Risk of Complications Even in High-Risk Veterans After Endoscopic Therapy for Biliary Stone Disease.

Samarth S Patel, Divyanshoo R Kohli, Jeannie Savas, Pritesh R Mutha, Alvin Zfass, Tilak U Shah

Abstract read
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In one paragraph

Article in Digestive diseases and sciences, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.7field-weighted citation impact, top 27% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 7 citations in OpenAlex.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 2 institutions in 1 country.

Samarth S PatelDivision of Gastroenterology and Hepatology, Department of Medicine, Virginia Commonwealth University, MCV Box 980342, Richmond, VA, 23298-0342, USA. patelsamarth@gmail.com.
Divyanshoo R KohliDivision of Gastroenterology and Hepatology, Department of Medicine, Virginia Commonwealth University, MCV Box 980342, Richmond, VA, 23298-0342, USA.
Jeannie SavasDepartment of Surgery, Hunter Holmes McGuire VA Medical Center, Richmond, VA, USA.
Pritesh R MuthaDivision of Gastroenterology and Hepatology, Department of Medicine, Virginia Commonwealth University, MCV Box 980342, Richmond, VA, 23298-0342, USA.
Alvin ZfassDivision of Gastroenterology and Hepatology, Department of Medicine, Virginia Commonwealth University, MCV Box 980342, Richmond, VA, 23298-0342, USA.
Tilak U ShahDivision of Gastroenterology and Hepatology, Department of Medicine, Virginia Commonwealth University, MCV Box 980342, Richmond, VA, 23298-0342, USA.
Virginia Commonwealth University · USHunter Holmes McGuire VA Medical Center · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundIn otherwise healthy patients, randomized trials have shown reduced mortality with cholecystectomy (CCY) when compared to non-operative management after endoscopic retrograde cholangiopancreatography (ERCP) for biliary stone disease. These findings may not apply to veterans with multiple comorbidities, who have an increased risk of postoperative complications.

aimsOur study assessed the benefit of CCY among veterans with multiple comorbidities.

methodsMedical records of patients undergoing ERCP for biliary stone-related diseases from July 2008 to December 2016 were reviewed. Among patients who did not undergo CCY, risk of postoperative complications or death with CCY was estimated using the American College of Surgeons National Surgery Quality Improvement Program risk calculator. Charlson comorbidity index (CCI) and American Society of Anesthesiologists classification system (ASA) were used to assess patient's functional status. The primary outcome was incidence of recurrent biliary events or death with non-operative management, compared to estimated risk of serious postoperative complications or death with CCY.

resultsA total of 152 patients met inclusion criteria, 81 of whom did not undergo CCY. Patients managed non-operatively were older and less medically fit than patients who underwent CCY. Biliary complications recurred in 23 patients managed non-operatively, including 3 deaths due to cholangitis. Among patients with CCI ≥ 3 and ASA ≥ 3 who were managed non-operatively (n = 43), the risk of serious biliary events was significantly higher than estimated risk of serious postoperative complications with laparoscopic CCY (26 vs 5%, p < 0.001).

conclusionOur study suggests that non-operative management is associated with a higher risk of complications than laparoscopic CCY, even among veterans with significant comorbidities.

Indexed as

Cholangiopancreatography, Endoscopic RetrogradeVeteransAgedAged, 80 and overCholecystectomy, LaparoscopicFemaleGallstonesHumansMaleMiddle AgedPostoperative ComplicationsRetrospective StudiesTreatment OutcomeBile duct diseasesCholecystectomyEndoscopic retrograde cholangiopancreatographyGallbladder diseasesLaparoscopic Cholecystectomy

Identifiers

PMID29380173
OpenAlexW2793292958

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.