Randial Pérez Leonardo José, Fernando Parra Juan, Aldana Dimas Guillermo
Cirugía General, Fundación Universitaria de Ciencias de la Salud (FUCS)-Hospital San José, Bogotá, Colombia.
Cirugía General, Fundación Universitaria de Ciencias de la Salud (FUCS)-Hospital San José, Bogotá, Colombia.
Cir Esp. 2014 Feb;92(2):107-13. doi: 10.1016/j.ciresp.2013.01.024. Epub 2013 Oct 4.
In mild gallstone pancreatitis, cholecystectomy decreases the risk of recurrence. This should be performed during the initial hospitalization, but even when this is performed, the hospital stay can be prolonged, with an increase in costs and morbidity. The aim of this study is to compare the complication rate between patients who underwent an early cholecystectomy (<48 hours) vs. a late one (>48 hours).
A systematic search was performed in the following data bases: PubMed, EMBASE, LILACS and Scielo. Articles on patients with acute, mild gallstone pancreatitis who required a cholecystectomy during their initial hospitalization were included and compared with those undergoing a late cholecystectomy, in order to evaluate the complications, number of days of hospitalization and need for readmission. The quality of the studies and the risks of bias were evaluated.
A total of 580 articles and summaries were identified which included 3 observational studies and a randomized clinical trial. A total of 636 patients who underwent a cholecystectomy during the initial hospitalization were included,. Ten of 207 (4.83%) in the early cholecystectomy group showed some type of complication, and 19 of 429 (4.42%) in the late cholecystectomy group, with a risk difference of -0.0016 IC 95% ([-0.04]-0.04). Three of the included studies should be considered of low quality and one of high quality. No publication bias was evidenced.
No differences in complication rate were found between patients who underwent an early cholecystectomy versus a late cholecystectomy; nevertheless, further studies should be carried out in order to confirm these findings.
在轻度胆石性胰腺炎中，胆囊切除术可降低复发风险。该手术应在初次住院期间进行，但即便如此，住院时间仍可能延长，成本和发病率也会增加。本研究旨在比较早期（<48小时）与晚期（>48小时）行胆囊切除术患者的并发症发生率。
在以下数据库进行系统检索：PubMed、EMBASE、LILACS和Scielo。纳入初次住院期间需要行胆囊切除术的急性轻度胆石性胰腺炎患者的文章，并与晚期行胆囊切除术的患者进行比较，以评估并发症、住院天数及再次入院需求。评估研究质量和偏倚风险。
共识别出580篇文章和摘要，其中包括3项观察性研究和1项随机临床试验。总共纳入了636例初次住院期间行胆囊切除术的患者。早期胆囊切除术组207例中有10例（4.83%）出现某种类型的并发症，晚期胆囊切除术组429例中有19例（4.42%）出现并发症，风险差异为-0.0016，95%置信区间为（[-0.04]-0.04）。纳入的研究中有3项应视为低质量，1项为高质量。未发现发表偏倚。
早期与晚期行胆囊切除术的患者在并发症发生率上未发现差异；然而，仍需进一步研究以证实这些发现。
