Early versus delayed laparoscopic cholecystectomy for acute cholecystitis.

摘要: BackgroundGallstones are present in about 10% to 15% of the adult western population. Between 1% and 4% become symptomatic a year. Cholecystectomy for gallstones is mainly performed after acute cholecystitis episode settles because fear higher morbidity conversion from laparoscopic cholecystectomy open during cholecystitis.ObjectivesThe aim was compare early (less than seven days onset symptoms) versus delayed (more six weeks index admission) with regards benefits harms.Search strategyWe searched T h e C o c r n H p t - B i l y G u d s R g r, f (C E N A L) L b y, M D I E, S x until November 2005.Selection criteriaWe considered inclusion all randomised clinical trials comparing cholecystitis.Data collection analysisWe collected data on characteristics trial, methodological quality trials, mortality, morbidity, rate, operating time, hospital stay each trial. We analysed both fixed-effect random-effects models using RevMan Analysis. For outcome we calculated odds ratio (OR) 95% confidence intervals (CI) based intention-to-treat analysis.Main resultsWe included five 451 patients randomised: 223 group 228 group. Surgery 222 216 There no mortality any trials. Four were high quality. statistically significant difference between two groups outcomes including bile duct injury (OR 0.63, CI 0.15 2.70) 0.84, 0.53 1.34). Various other analyses ' available case analysis', risk difference, statistical methods overcome zero-event trials' showed measured. total 40 (17.5%) had undergo emergency due non-resolving or recurrent cholecystitis; 18 (45%) these procedure. The three shorter compared group.Authors' conclusionsEarly seems safe shortens stay. majority occurred rarely; hence, wide. Therefore, further issue needed.