Evidence map›Paper›PMID 30167953›Full record

SynthesisSurgical endoscopy2018

Early versus delayed laparoscopic cholecystectomy for acute cholecystitis: an up-to-date meta-analysis of randomized controlled trials.

Yunxiao Lyu, Yunxiao Cheng, Bin Wang, Sicong Zhao, Liang Chen

Abstract readMeta-Analysis
PubMed Publisher
In one paragraph

Synthesis in Surgical endoscopy, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 31 papers, 5 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
31citing papers in PubMed, 5 pooled it
–field-weighted citation impact
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

31 citing papers in PubMed, 5 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Pooled it
  5. Pooled it
  6. Review
  7. Review
  8. Article
  9. Article
  10. Review
  11. Article
  12. Article
  13. Review
  14. Review
  15. Article
  16. Review
  17. Article
  18. Article
  19. Article
  20. 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

5 authors.

Yunxiao LyuDepartment of Hepatobiliary Surgery, Dongyang People's Hospital, Dongyang, 322100, Zhejiang, China. lvyunxiao1986@gmail.com.ORCID 0000-0002-2795-9698
Yunxiao ChengDepartment of Hepatobiliary Surgery, Dongyang People's Hospital, Dongyang, 322100, Zhejiang, China.
Bin WangDepartment of Hepatobiliary Surgery, Dongyang People's Hospital, Dongyang, 322100, Zhejiang, China.
Sicong ZhaoDepartment of Hepatobiliary Surgery, Dongyang People's Hospital, Dongyang, 322100, Zhejiang, China.
Liang ChenDepartment of Hepatobiliary Surgery, Dongyang People's Hospital, Dongyang, 322100, Zhejiang, China.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThis study was performed to compare the safety and effectiveness of early laparoscopic cholecystectomy (ELC) with delayed laparoscopic cholecystectomy (DLC) for acute cholecystitis (AC).

methodsA systematic search was performed of PubMed, Embase, Web of Science, the Cochrane Central Register of Controlled Trials, and ClinicalTrials.gov from 1 August 1990 to 1 April 2018. Randomized controlled trials comparing ELC versus DLC were included. The primary outcome was bile duct injury (BDI) and bile leakage. The secondary outcomes were wound infection, total complications, conversion to open surgery, operation time, and total hospital stay. The statistical analysis was performed using Review Manager (RevMan) version 5.3 software (Cochrane Informatics and Knowledge Management Department).

resultsFifteen RCTs were included. A meta-analysis showed no significant differences between ELC and DLC in terms of BDI (risk ratio [RR] 0.79; 95% confidence interval [CI] 0.23-2.79; p = 0.72) (in all subgroups of surgery: within 7, 4, and 3 days) (p = 0.22, 0.49, 0.49, respectively) or bile leakage (RR 2.05; 95% CI 0.98-4.31; p = 0.06). No significant differences were found in the rate of wound infection (RR 0.75; 95% CI 0.51-1.11; p = 0.15), total complications (RR 0.90; 95% CI 0.58-1.39; p = 0.63), or conversion to open surgery (RR 0.94; 95% CI 0.74-1.21; p = 0.64). There were no significant differences in the operation time between ELC and DLC (mean difference [MD] = 9.29 min; 95% CI - 0.41 to 18.98; p = 0.06), but ELC was associated with a longer surgery time within 7 days (MD = 16.49 min; 95% CI 2.10-30.88; p = 0.02). The pooled results showed that ELC was associated with a significantly shorter duration of hospital stay (MD = - 3.07 days; 95% CI - 3.98 to - 2.16; p < 0.00001), but with no significantly difference with postoperative hospital stay (MD = 0.45 days; 95% CI - 0.38 to 1.29; p = 0.29).

conclusionELC appears as safe and effective as DLC for acute cholecystitis within 7 days from presentation and may shorten the total hospital stay.

Indexed as

Cholecystectomy, LaparoscopicTime-to-TreatmentCholecystitis, AcuteHumansRandomized Controlled Trials as TopicTreatment OutcomeAcute cholecystitisLaparoscopic cholecystectomyMeta-analysisSystematic review

Identifiers

PMID30167953

What OpenQuestion holds

Textmetadata
Read underepoch 390

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.