Evidence map›Paper›PMID 33025256›Full record

ArticleSurgical endoscopy2021

Surgical trends in the management of acute cholecystitis during pregnancy.

Vincent Cheng, Kazuhide Matsushima, Kulmeet Sandhu, Matthew Ashbrook, Koji Matsuo, Kenji Inaba, Demetrios Demetriades

Abstract read
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In one paragraph

Article in Surgical endoscopy, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed, 2 pooled it
5.9field-weighted citation impact, top 3% 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

7 citing papers in PubMed, 2 syntheses or guidelines pooled it, 39 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Review
  4. Article
  5. Article
  6. Review
  7. 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

7 authors at 1 institution in 1 country.

Vincent ChengDivision of Acute Care Surgery, Department of Surgery, University of Southern California, 2051 Marengo Street, Inpatient Tower, C5L100, Los Angeles, CA, 90033, USA.
Kazuhide MatsushimaDivision of Acute Care Surgery, Department of Surgery, University of Southern California, 2051 Marengo Street, Inpatient Tower, C5L100, Los Angeles, CA, 90033, USA. kazuhide.matsushima@med.usc.edu.ORCID 0000-0001-9625-5363
Kulmeet SandhuDivision of Upper GI and General Surgery, Department of Surgery, University of Southern California, Los Angeles, CA, USA.
Matthew AshbrookDivision of Acute Care Surgery, Department of Surgery, University of Southern California, 2051 Marengo Street, Inpatient Tower, C5L100, Los Angeles, CA, 90033, USA.
Koji MatsuoDepartment of Obstetrics and Gynecology, University of Southern California, Los Angeles, CA, USA.
Kenji InabaDivision of Acute Care Surgery, Department of Surgery, University of Southern California, 2051 Marengo Street, Inpatient Tower, C5L100, Los Angeles, CA, 90033, USA.
Demetrios DemetriadesDivision of Acute Care Surgery, Department of Surgery, University of Southern California, 2051 Marengo Street, Inpatient Tower, C5L100, Los Angeles, CA, 90033, USA.
University of Southern California · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundSince 2007, clinical practice guidelines by the Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) recommend early surgical management with laparoscopic cholecystectomy for pregnant women with symptomatic gallbladder disease regardless of trimester. However, little is known about practice patterns in the management of pregnant patients with acute cholecystitis. This study aims to examine nationwide trends in the surgical management of acute cholecystitis, as well as their impact on clinical outcomes during pregnancy.

methodsThe National Inpatient Sample was queried for all pregnant women diagnosed with acute cholecystitis between January 2003 and September 2015. After applying appropriate weights, multivariate regression analysis adjusted for patient- and hospital-level characteristics and quantified the impact of discharge year (2003-2007 versus 2008-2015) on cholecystectomy rates and timing of surgery. Multivariate regression analysis was also used to examine the impact of same admission cholecystectomy and its timing on maternal and fetal outcomes.

resultsA total of 23,939 pregnant women with acute cholecystitis satisfied our inclusion criteria. The median age was 26 years (interquartile range: 22-30). During the study period, 36.3% were managed non-operatively while 59.6% and 4.1% underwent laparoscopic and open cholecystectomy, respectively. After adjusting for covariates, laparoscopic cholecystectomy was more commonly performed after 2007 (odds ratio [OR] 1.333, p < 0.001). Furthermore, time from admission to surgery was significantly shorter in the latter study period (regression coefficient -0.013, p < 0.001). Compared to non-operative management, laparoscopic cholecystectomy for acute cholecystitis was significantly associated with lower rates of preterm delivery, labor, or abortion (OR 0.410, p < 0.001). Each day that laparoscopic cholecystectomy was delayed significantly associated with an increased risk of fetal complications (OR 1.173, p < 0.001).

conclusionsThis nationwide study exhibits significant trends favoring surgical management of acute cholecystitis during pregnancy. Although further studies are still warranted, early laparoscopic cholecystectomy should be considered in pregnant patients with acute cholecystitis.

Indexed as

Cholecystectomy, LaparoscopicCholecystitis, AcuteGallbladder DiseasesAdultCholecystectomyFemaleHumansInfant, NewbornLength of StayPregnancyAcute cholecystitisCholecystectomyManagementOutcomesPregnancyTrends

Identifiers

PMID33025256
OpenAlexW3092077646

What OpenQuestion holds

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Registered trials

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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.