Early versus delayed laparoscopic cholecystectomy for acute cholecystitis: an up-to-date meta-analysis of randomized controlled trials

Abstract

ELC appears as safe and effective as DLC for acute cholecystitis within 7 days from presentation and may shorten the total hospital stay.

The timing of laparoscopic cholecystectomy in acute cholecystitis: importance of first 72 hours and oxidative stress markers

“…These findings are similar to many studies in the literature, but in these studies, it was seen that the patients in the late group operated between 8 days and 12 weeks. [17,18,[21][22][23][24] In one retrospective study, it is shorter in the early cholecystectomy group. [16] A meta-analysis study involving fifteen randomized controlled trials reported that the operative time in the early cholecystectomy group (seven days following symptom onset) was significantly longer.…”

“…The time limit for early LC is defined in some studies as the first 72 hours following symptom onset, [16][17][18] and in other studies, it is describe as the first 1 to 10 days. [19][20][21][22][23] Regardless of the timing of the concept of "early", all of the above-mentioned studies showed that early LC was associated with a reduction in the length of stay, workdays lost, and costs without an increase in conversion or perioperative complications. [16][17][18][19][20][21][22][23] Another important issue in the delayed group (1-8 weeks) is gallstone-related morbidity during the waiting period for a cholecystectomy.…”

“…[19][20][21][22][23] Regardless of the timing of the concept of "early", all of the above-mentioned studies showed that early LC was associated with a reduction in the length of stay, workdays lost, and costs without an increase in conversion or perioperative complications. [16][17][18][19][20][21][22][23] Another important issue in the delayed group (1-8 weeks) is gallstone-related morbidity during the waiting period for a cholecystectomy. [16][17][18]21,23] The most common morbidity is the non-resolution or recurrence of cholecystitis, which occurred in 18.3-29.5%…”

“…[16] A meta-analysis study involving fifteen randomized controlled trials reported that the operative time in the early cholecystectomy group (seven days following symptom onset) was significantly longer. [22] In an inflammatory condition, such as AC, inflammatory cells (for example, granulocytes and mastocytes) are recruited to the site of inflammation, and they subsequently cause an increase in the uptake of oxygen and, thus, free radicals. Free radicals cause lipid peroxidation in cellular membranes, which results in increased permeability, interstitial edema, and more…”

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“…Los principales efectos se deben a la presión intra abdominal elevada que conduce a diversas alteraciones respiratorias, cardiovasculares y neurológicas. 2,3 Totaltrack es un dispositivo versátil, diseñado para el manejo de intervenciones previstas o inesperadas en pacientes de vía aérea difícil, incorpora un sistema de monitorización y una cámara reutilizable que se adapta rápidamente. Es el único dispositivo que permite un aporte de oxígeno a presión positiva durante la ventilación e intubación y la extubación bajo una visión continua.…”