Evidence map›Paper›PMID 39538278›Full record

Trial reportWorld journal of emergency surgery : WJES2024

Ultrasonic dissection versus electrocautery dissection in laparoscopic cholecystectomy for acute cholecystitis: a randomized controlled trial (SONOCHOL-trial).

My Blohm, Gabriel Sandblom, Lars Enochsson, Yücel Cengiz, Haytham Bayadsi, Joakim Hennings, Angelica Diaz Pannes, Erik Stenberg, Kerstin Bewö, Johanna Österberg

Registry-linked trialAbstract readRandomized Controlled TrialMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Trial report in World journal of emergency surgery : WJES, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03014817 (Ultrasonically Activated Scalpel Versus Electrocautery Based Dissection in Acute Cholecystitis. A Randomized, Double Blind, Multicenter Study), which is not on this map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 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.

NCT03014817 nacompletednot on this map

Ultrasonically Activated Scalpel Versus Electrocautery Based Dissection in Acute Cholecystitis. A Randomized, Double Blind, Multicenter Study

TypeinterventionalSponsorKarolinska InstitutetRan2019 to 2023Enrolled180ConditionsCholecystitis, AcuteArmsUltrasonically activated scalpel, Electrocautery
3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Review
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

10 authors.

My BlohmDepartment of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden. my.blohm@regiondalarna.se.
Gabriel SandblomDepartment of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden.
Lars EnochssonDepartment of Diagnostics and Intervention, Surgery, Umeå University, Umeå, Sweden.
Yücel CengizDepartment of Diagnostics and Intervention, Surgery, Umeå University, Umeå, Sweden.
Haytham BayadsiDepartment of Diagnostics and Intervention, Surgery, Umeå University, Umeå, Sweden.
Joakim HenningsDepartment of Diagnostics and Intervention, Surgery, Umeå University, Umeå, Sweden.
Angelica Diaz PannesDepartment of Surgery, Södertälje Hospital, Södertälje, Sweden.
Erik StenbergDepartment of Surgery, Faculty of Medicine, and Health, Örebro University Hospital, Örebro, Sweden.
Kerstin BewöDepartment of Surgery, Falu Lasarett, Falun, Sweden.
Johanna ÖsterbergDepartment of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden.

Funding

Centrum fÖr Klinisk Forskning Dalarna CKFUU-96329Regionala Forskningsrådet Uppsala/Örebro RFR-980175Stockholm läns landsting 20190336
6 · The paper itself

Abstract

backgroundLaparoscopic cholecystectomy with ultrasonic dissection presents a compelling alternative to conventional electrocautery. The evidence for elective cholecystectomy supports the adoption of ultrasonic dissection, citing advantages such as reduced operating time, diminished bleeding, shorter hospital stays and decreased postoperative pain and nausea. However, the efficacy of this procedure in emergency surgery and patients diagnosed with acute cholecystitis remains uncertain. The aim of this study was to compare outcomes of electrocautery and ultrasonic dissection in patients with acute cholecystitis.

methodsA randomized, parallel, double-blinded, multicentre controlled trial was conducted across eight Swedish hospitals. Eligible participants were individuals aged ≥ 18 years with acute cholecystitis lasting ≤ 7 days. Laparoscopic cholecystectomy was performed in the emergency setting as soon as local circumstances permitted. Random allocation to electrocautery or ultrasonic dissection was performed in a 1:1 ratio. The primary endpoint was the total complication rate, analysed using an intention-to-treat approach. The primary outcome was analysed using logistic generalized estimated equations. Patients, postoperative caregivers, and follow-up personnel were blinded to group assignment.

resultsFrom September 2019 to March 2023, 300 patients were enrolled and randomly assigned to electrocautery dissection (n = 148) and ultrasonic dissection (n = 152). No significant difference in complication rate was observed between the groups (risk difference [RD] 1.6%, 95% confidence interval [CI], - 7.2% to 10.4%, P = 0.720). No significant disparities in operating time, conversion rate, hospital stay or readmission rates between the groups were noted. Haemostatic agents were more frequently used in electrocautery dissection (RD 10.6%, 95% CI, 1.3% to 19.8%, P = 0.025).

conclusionsUltrasonic dissection and electrocautery dissection demonstrate comparable risks for complications in emergency surgery for patients with acute cholecystitis. Ultrasonic dissection is a viable alternative to electrocautery dissection or can be used as a complementary method in laparoscopic cholecystectomy for acute cholecystitis.

trial registrationThe trial was registered prior to conducting the research on http://clinical. TRIALS: gov , NCT03014817.

Indexed as

Cholecystectomy, LaparoscopicCholecystitis, AcuteElectrocoagulationAdultAgedDissectionDouble-Blind MethodFemaleHumansLength of StayMaleMiddle AgedOperative TimePostoperative ComplicationsSwedenAcute care surgeryAcute cholecystitisElectrocoagulationElectrosurgeryGeneral surgeryLaparoscopic cholecystectomyMinimally invasive surgical proceduresUltrasonic surgical procedures

Identifiers

PMID39538278
PMCPMC11562708

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Registered trials

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.