Artículos de revistas
Uncomplicated Acute Cholecystitis: Early Or Delayed Laparoscopic Cholecystectomy? [colecistite Aguda Não-complicada: Colecistectomia Laparoscópica Precoce Ou Tardia?]
Registro en:
Revista Do Colegio Brasileiro De Cirurgioes. , v. 39, n. 5, p. 436 - 440, 2012.
1006991
10.1590/S0100-69912012000500017
2-s2.0-84870712285
Autor
Sankarankutty A.
Da Luz L.T.
De Campos T.
Rizoli S.
Fraga G.P.
Nascimento Jr. B.
Institución
Resumen
Recent meta-analyses suggested that early laparoscopic cholecystectomy (within 1 week of symptom onset) for uncomplicated acute gallbladder disease is safe and feasible. However, surveys on surgical practices indicated that early laparoscopic cholecystectomy is performed by only a minority of surgeons. Furthermore, the exact time-point for performing this procedure as well as its costeffectiveness remain a matter of debate. The TBE - CiTE Journal Club performed a critical appraisal of the most relevant evidence recently published on timing of laparoscopic cholecystectomy and its cost-effectiveness for the management of uncomplicated acute cholecystitis and provides evidence-based recommendations on the topic. The literature encompasses small trials with high risk of biases. It suggests that early laparoscopic cholecystectomy is safe and shortens hospital stay. There is scarcity of well-designed and large cost-utility analyses. The following main recommendations were generated: (1) Early laparoscopic cholecystectomy should be attempted as the first-line treatment within one week of symptoms onset; and (2) The cost-effectiveness of early laparoscopic cholecystectomy should be evaluated at the individual hospital level, taking into consideration local resources such as the availability of trained personal, operating room and laparoscopic equipment. 39 5 436 440 Halldestam, I., Enell, E.L., Kullman, E., Borch, K., Development of symptoms and complications in individuals with asymptomatic gallstones (2004) Br J Surg., 91 (6), pp. 734-738 Rutledge, D., Jones, D., Rege, R., Consequences of delay in surgical treatment of biliary disease (2000) Am J Surg., 180 (6), pp. 466-469 Gurusamy, K., Samraj, K., Gluud, C., Wilson, E., Davidson, B.R., Metaanalysis of randomized controlled trials on the safety and effectiveness of early versus delayed laparoscopic cholecystectomy for acute cholecystitis (2010) Br J Surg, 97 (2), pp. 141-150. , Erratum in: Br J Surg. 2010;97(4):624 Lau, H., Lo, C.Y., Patil, N.G., Yuen, W.K., Early versus delayed-interval laparoscopic cholecystectomy for acute cholecystitis: A metaanalysis (2006) Surg Endosc., 20 (1), pp. 82-87 Wilson, E., Gurusamy, K., Gluud, C., Davidson, B.R., Cost-utility and valueof-information analysis of early versus delayed laparoscopic cholecystectomy for acute cholecystitis (2010) Br J Surg., 97 (2), pp. 210-219 Livingston, E.H., Rege, R.V., A nationwide study of conversion from laparoscopic to open cholecystectomy (2004) Am J Surg., 188 (3), pp. 205-211 Senapati, P.S., Bhattarcharya, D., Harinath, G., Ammori, B.J., A survey of the timing and approach to the surgical management of cholelithiasis in patients with acute biliary pancreatitis and acute cholecystitis in the UK (2003) Ann R Coll Surg Engl., 85 (5), pp. 306-312 Banz, V., Gsponer, T., Candinas, D., Güller, U., Population-based analysis of 4113 patients with acute cholecystitis: Defining the optimal time-point for laparoscopic cholecystectomy (2011) Ann Surg., 254 (6), pp. 964-970 McAfee, D.A., Humes, D.J., Bouliotis, G., Beckingham, I.J., Whynes, D.K., Lobo, D.N., Prospective randomized trial using cost-utility analysis of early versus delayed laparoscopic cholecystectomy for acute gallbladder disease (2009) Br J Surg., 96 (9), pp. 1031-1040