HPB : the official journal of the International Hepato Pancreato Biliary Association · 2025
Randomized controlled trial of early versus late cholecystectomy in patients with mild acute pancreatitis.
СтатьяРандомизированное исследованиеСравнительное исследованиеНазвание и аннотация: Перевод в очереди
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Zhou Wangxin, Ji Shengwei, Zhang Chunjie, Liu Baoqing, Hong Hong, Pei Maowei
Аннотация
BACKGROUND: The optimal timing of laparoscopic cholecystectomy (LC) in mild acute biliary pancreatitis (MABP) remains debated. This study compared early (within 72 h) versus delayed LC outcomes.
METHODS: A randomized trial at Zhejiang Hospital assigned 120 MABP patients to early or delayed LC. Demographics, complications, operative outcomes, and hospital stay were analyzed.
RESULTS: There were no differences in baseline demographics, overall complication rates (10 % vs. 8.3 %; P = 0.752), intraoperative blood loss (33.93 ± 17.68 mL vs. 37.08 ± 30.97 mL; P = 0.593) or conversion to open surgery rate (3.3 % vs. 5.0 %; P = 1.00) between the two groups. There were no recurrent biliary events, postoperative readmissions, reoperations, or deaths in either group; However, the early LC group demonstrated significant advantages in intraoperative adhesions (80 % vs. 93.3 %; P < 0.05), procedure time (61.87 ± 12.54 vs. 66.77 ± 12.11 min, P < 0.05) and the length of hospital stay (5 days vs. 7 days, P < 0.05).
CONCLUSION: For patients with MABP, early LC performed within 72 h of admission significantly reduces hospital length of stay and procedure time, without increasing perioperative complication rates or measures of procedural difficulty.
METHODS: A randomized trial at Zhejiang Hospital assigned 120 MABP patients to early or delayed LC. Demographics, complications, operative outcomes, and hospital stay were analyzed.
RESULTS: There were no differences in baseline demographics, overall complication rates (10 % vs. 8.3 %; P = 0.752), intraoperative blood loss (33.93 ± 17.68 mL vs. 37.08 ± 30.97 mL; P = 0.593) or conversion to open surgery rate (3.3 % vs. 5.0 %; P = 1.00) between the two groups. There were no recurrent biliary events, postoperative readmissions, reoperations, or deaths in either group; However, the early LC group demonstrated significant advantages in intraoperative adhesions (80 % vs. 93.3 %; P < 0.05), procedure time (61.87 ± 12.54 vs. 66.77 ± 12.11 min, P < 0.05) and the length of hospital stay (5 days vs. 7 days, P < 0.05).
CONCLUSION: For patients with MABP, early LC performed within 72 h of admission significantly reduces hospital length of stay and procedure time, without increasing perioperative complication rates or measures of procedural difficulty.