COMPARISON OF RESULTS OF EARLY AND DELAYED LAPAROSCOPIC CHOLECYSTECTOMY FOR TREATMENT OF ACUTE CHOLECYSTITIS: META-ANALYSIS OF PROSPECTIVE RANDOMIZED CONTROLLED TRIALS

Abstract

Background: in the previous researches on subject of terms of cholecystectomy in acute cholecystitis only part of all existing randomized controlled trials were analyzed, economic effect was not examined. The objective of this study was to find optimal terms of operative intervention in acute cholecystitis. Materials and methods: databases PubMed, EMBASE, Cochrane Library и Web of Science were searched for randomized controlled trials, which compared results of treatment of acute cholecystitis with early and delayed laparoscopic cholecystectomy. Results: 17 prospective randomized controlled trials with 1756 patients were included in meta-analysis. Decrease in mean hospital stay (Mean difference -3,10; 95% CI -3,51,-2,69) and cost of treatment (Standardized mean difference -0,78; 95% CI -1,31; -0,26) were found for patients from group of early laparoscopic cholecystectomy. Differences in mortality, overall complications, conversion rate, iatrogenic bile injury and mean operative time were not found. Conclusion: applying of early laparoscopic cholecystectomy in treatment of acute cholecystitis (during the first week after appearing of symptoms) noticeably decrease amount of time and money, spent on treatment of patient, not creating an increased risk of complications.

Keywords

• острый холецистит
• лапароскопическая холецистэктомия
• мета-анализ