The optimal timing of laparoscopic cholecystectomy in patients with mild gallstone pancreatitis: A meta-analysis.

Abstract

Background:The optimal timing of laparoscopic cholecystectomy (LC) in patients with mild acute gallstone pancreatitis (MAGP) is controversial. The aim of this study was to systematically evaluate and compare the safety and efficacy of early laparoscopic cholecystectomy (ELC) and delayed laparoscopic cholecystectomy (DLC) in patients with MAGP.Methods:A strict search was conducted of the electronic databases, including PubMed, MEDLINE Embase, the ISI Web of Science, and Cochrane Library for all relevant English literature and RevMan5.3 software for statistical analysis was used.Results:A total of 19 studies comprising 2639 patients were included. There was no significant difference in intraoperative complications [risk ratio (RR) = 1.46; 95% confidence interval (CI) = 0.88–2.41; P = .14)], postoperative complications (RR = 0.81; 95% CI = 0.58–1.14; P = .23), rate of conversion to open cholecystectomy (RR = 1.00; 95% CI = 0.75–1.33; P = .99), operative time (MD = 1.60; 95% CI = −1.36–4.56; P = .29), and rate of readmission (RR = 0.63; 95% CI = 0.19–2.10; P = .45) between the ELC and DLC groups. However, the ELC group was significantly correlated with lower length of hospital stay (MD = −2.01; 95% CI = −3.15 to −0.87; P = .0006), fewer gallstone-related events rates (RR = 0.17; 95% CI = 0.07–0.44; P = .0003), and lower endoscopic retrograde cholangiopancreatography (ERCP) usage (RR = 0.83; 95% CI = 0.71–0.97; P = .02) compared with the DLC group.Conclusion:Early laparoscopic cholecystectomy is safe and effective for patients with MAGP, but the indications and contraindications must be strictly controlled.