Timing of Cholecystectomy for Acute Calculous Cholecystitis: A Meta-Analysis

摘要: METHODS: Pertinent studies were selected from the Medline, Embase, Cancerlit, HealthSTAR and Cochrane Library Databases, references published articles, reviews. Twelve prospective randomized trials (9 addressing open cholecystectomy 3 laparoscopic cholecystectomy) selected. Conventional meta-analysis according to DerSimonian Laird method was used for pooling of results. The rate difference (RD) (95% CI) number needed treat (NNT) as a measure therapeutic effect. RESULTS: Cumulative operative perioperative mortality morbidity 0.9% 17.8%, respectively, 0% 13.1%, cholecystectomy. pooled RD complications in early surgery 1.37% CI = −3.78% 6.53%; p 0.2) 3.11% −15.10% 8.87%; 0.6) In cumulative conversion 21.5%. −7.99% −18.46% 2.47%; 0.1; NNT 13). Total hospital stay (mean ± SD) significantly shorter group (9.6 2.5 days vs 17.8 5.8 days; < 0.0001). More than 20% patients referred delayed fail respond conservative management or suffer recurrent cholecystitis interval period. CONCLUSIONS: Early operation (open laparoscopic) does not carry higher risk compared should be preferred surgical approach with acute lithiasic cholecystitis.