Optimizing cholecystectomy time in moderate acute biliary pancreatitis: A randomized clinical trial study
Background: In mild to moderate gallstone pancreatitis, cholecystectomy is the most appropriate treatment for prevention of further biliary attacks. However, the timing of cholecystectomy is not precisely determined. The present study was conducted to compare outcomes of very early (within 48 h) ver...
Main Authors: | , , , , |
---|---|
Format: | Article |
Language: | English |
Published: |
Elsevier
2020-02-01
|
Series: | Heliyon |
Subjects: | |
Online Access: | http://www.sciencedirect.com/science/article/pii/S2405844020302334 |
id |
doaj-00b9c85b21d944688f0b62b848864774 |
---|---|
record_format |
Article |
spelling |
doaj-00b9c85b21d944688f0b62b8488647742020-11-25T02:07:07ZengElsevierHeliyon2405-84402020-02-0162e03388Optimizing cholecystectomy time in moderate acute biliary pancreatitis: A randomized clinical trial studyAbdoulhossein Davoodabadi0Esmail Beigmohammadi1Hamidreza Gilasi2Abbas Arj3Hossein Taheri nassaj4Departments of surgery, Trauma Research Center, Kashan University of Medical Sciences, Kashan, Iran; Corresponding author.Departments of surgery, Trauma Research Center, Kashan University of Medical Sciences, Kashan, IranDepartments of Epidemiology& Biostatistics, Kashan University of Medical Sciences, Kashan, IranDepartment of Internal Medicine, Kashan University of Medical Sciences, Kashan, IranDepartments of surgery, Trauma Research Center, Kashan University of Medical Sciences, Kashan, Iran; Departments of surgery, Kashan University of Medical Sciences, Kashan, IranBackground: In mild to moderate gallstone pancreatitis, cholecystectomy is the most appropriate treatment for prevention of further biliary attacks. However, the timing of cholecystectomy is not precisely determined. The present study was conducted to compare outcomes of very early (within 48 h) versus delayed (more than 1 week) laparoscopic cholecystectomy in patients with acute biliary pancreatitis (ABP). Methods: This randomized clinical trial study was conducted in Shahid Beheshti Hospital of Kashan University of Medical Sciences from September 2016 to Mar 2019. Two hundred and eight cases with mild to moderate ABP were randomly assigned to 2 groups, with 104 patients in group 1 (operation within 48 h) and 104 in group 2 (operation after one week). Age, sex, biochemical parameters, clinical manifestation at the time of admission, operation time, recurrent biliary problems, relapse, peri-operative complications, conversion rate, and hospital length of stay in the two groups were recorded and compared. In addition, Ranson's score and Revised Atlanta criteria, the American Society of Anaesthesiologists Physical Status ASA-PS, Charlson Co-Morbidity Index (CCI), complexity of surgery and Clavien-Dindo score were also determined. Results: There were no differences in demographics, peri-operative complications 4 (4%) vs. 4 (4%), P = 1), conversion rate (10.6% vs. 11.5%; P = 0.825) and procedure time (83 vs. 81 minutes, P = 0.110) between the two groups. There were no deaths in either group; however, the length of hospital stay was shorter in the early group compared to the delayed one, (3.66 ± 1.12 vs. 10.35 ± 1.76, P < 0.001). Conclusion: Cholecystectomy within 48 h decreases significantly the length of hospital stay, without any difference in conversion rate, procedure time, or complication rate.http://www.sciencedirect.com/science/article/pii/S2405844020302334Biological sciencesHealth sciencesSurgeryInternal medicineAcute biliary pancreatitisLaparoscopic cholecystectomy |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Abdoulhossein Davoodabadi Esmail Beigmohammadi Hamidreza Gilasi Abbas Arj Hossein Taheri nassaj |
spellingShingle |
Abdoulhossein Davoodabadi Esmail Beigmohammadi Hamidreza Gilasi Abbas Arj Hossein Taheri nassaj Optimizing cholecystectomy time in moderate acute biliary pancreatitis: A randomized clinical trial study Heliyon Biological sciences Health sciences Surgery Internal medicine Acute biliary pancreatitis Laparoscopic cholecystectomy |
author_facet |
Abdoulhossein Davoodabadi Esmail Beigmohammadi Hamidreza Gilasi Abbas Arj Hossein Taheri nassaj |
author_sort |
Abdoulhossein Davoodabadi |
title |
Optimizing cholecystectomy time in moderate acute biliary pancreatitis: A randomized clinical trial study |
title_short |
Optimizing cholecystectomy time in moderate acute biliary pancreatitis: A randomized clinical trial study |
title_full |
Optimizing cholecystectomy time in moderate acute biliary pancreatitis: A randomized clinical trial study |
title_fullStr |
Optimizing cholecystectomy time in moderate acute biliary pancreatitis: A randomized clinical trial study |
title_full_unstemmed |
Optimizing cholecystectomy time in moderate acute biliary pancreatitis: A randomized clinical trial study |
title_sort |
optimizing cholecystectomy time in moderate acute biliary pancreatitis: a randomized clinical trial study |
publisher |
Elsevier |
series |
Heliyon |
issn |
2405-8440 |
publishDate |
2020-02-01 |
description |
Background: In mild to moderate gallstone pancreatitis, cholecystectomy is the most appropriate treatment for prevention of further biliary attacks. However, the timing of cholecystectomy is not precisely determined. The present study was conducted to compare outcomes of very early (within 48 h) versus delayed (more than 1 week) laparoscopic cholecystectomy in patients with acute biliary pancreatitis (ABP). Methods: This randomized clinical trial study was conducted in Shahid Beheshti Hospital of Kashan University of Medical Sciences from September 2016 to Mar 2019. Two hundred and eight cases with mild to moderate ABP were randomly assigned to 2 groups, with 104 patients in group 1 (operation within 48 h) and 104 in group 2 (operation after one week). Age, sex, biochemical parameters, clinical manifestation at the time of admission, operation time, recurrent biliary problems, relapse, peri-operative complications, conversion rate, and hospital length of stay in the two groups were recorded and compared. In addition, Ranson's score and Revised Atlanta criteria, the American Society of Anaesthesiologists Physical Status ASA-PS, Charlson Co-Morbidity Index (CCI), complexity of surgery and Clavien-Dindo score were also determined. Results: There were no differences in demographics, peri-operative complications 4 (4%) vs. 4 (4%), P = 1), conversion rate (10.6% vs. 11.5%; P = 0.825) and procedure time (83 vs. 81 minutes, P = 0.110) between the two groups. There were no deaths in either group; however, the length of hospital stay was shorter in the early group compared to the delayed one, (3.66 ± 1.12 vs. 10.35 ± 1.76, P < 0.001). Conclusion: Cholecystectomy within 48 h decreases significantly the length of hospital stay, without any difference in conversion rate, procedure time, or complication rate. |
topic |
Biological sciences Health sciences Surgery Internal medicine Acute biliary pancreatitis Laparoscopic cholecystectomy |
url |
http://www.sciencedirect.com/science/article/pii/S2405844020302334 |
work_keys_str_mv |
AT abdoulhosseindavoodabadi optimizingcholecystectomytimeinmoderateacutebiliarypancreatitisarandomizedclinicaltrialstudy AT esmailbeigmohammadi optimizingcholecystectomytimeinmoderateacutebiliarypancreatitisarandomizedclinicaltrialstudy AT hamidrezagilasi optimizingcholecystectomytimeinmoderateacutebiliarypancreatitisarandomizedclinicaltrialstudy AT abbasarj optimizingcholecystectomytimeinmoderateacutebiliarypancreatitisarandomizedclinicaltrialstudy AT hosseintaherinassaj optimizingcholecystectomytimeinmoderateacutebiliarypancreatitisarandomizedclinicaltrialstudy |
_version_ |
1724931062801367040 |