ArticleJSLS : Journal of the Society of Laparoendoscopic Surgeons
Gall Bladder Empyema: Early Cholecystectomy during the Index Admission Improves Outcomes.
Article in JSLS : Journal of the Society of Laparoendoscopic Surgeons. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04405713 (Assessment of Different Timing for Early Laparoscopic Cholecystectomy in Acute Calcular Cholecystitis), which is not on this map. Cited by 3 papers.
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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.
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.
Assessment of Different Timing for Early Laparoscopic Cholecystectomy in Acute Calcular Cholecystitis (Multicentric Study)
Who cites it
3 citing papers in PubMed.
- Reinterventions following laparoscopic cholecystectomy and bile duct exploration. A review of prospective data from 5740 patients.Surgical endoscopy · 2022Review
- Value of nonenhanced CT combined with laboratory examinations in the diagnosis of acute suppurative cholecystitis treated with percutaneous cholecystostomy: a retrospective study.BMC gastroenterology · 2022Article
- Open conversion in laparoscopic cholecystectomy and bile duct exploration: subspecialisation safely reduces the conversion rates.Surgical endoscopy · 2022Article
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesWe aim to evaluate our policy of index admission management of gall bladder empyema and the effect of the timing of surgery on the outcomes.
methodsWe analyzed a series of 5400 laparoscopic cholecystectomies. Data were collected prospectively over 26 y. Patients were divided into two groups: group 1, intervention within 72 h, and group 2, intervention after 72 h of admission. We had a policy of intention to treat during the index admission, but delays sometimes occurred because of late referral, a need to optimize patients, availability of theater time, or the biliary surgeon being on leave. The groups were then compared with regard to the duration of surgery, the difficulty grading, complications, hospital stay, and conversion rate.
resultsA total of 372 patients were included; 160 (43%) operated on within 72 h (group 1) and 212 (57%) after 72 h (group 2). There was no statistically significant difference between the two groups with regard to the operation time, conversion rate, and complications rate. The difference in total hospital stay was, however, statistically significant.
conclusionSurgical management of empyema should be offered as soon as possible after admission as with any acute cholecystitis. Surgery carried out after 72 h of admission is only associated with longer hospital stay but no statistically significant differences in other outcome parameters. In the presence of specialist expertise, fitness for surgery should be the determining factor of whether or not to offer surgery to these patients, regardless of the interval since their admission.
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