Management of Acute Cholecystitis in High-Risk Patients: Percutaneous Gallbladder Drainage as a Definitive Treatment vs. Emergency Cholecystectomy-Systematic Review and Meta-Analysis.
Roberto CirocchiLavinia AmatoSerena UnganiaMassimo BuononatoGiovanni Domenico TebalaBruno CirilloStefano AveniaValerio CozzaGianluca CostaRichard Justin DaviesPaolo SapienzaFederico CoccoliniAndrea MingoliMassimo ChiarugiGioia BrachiniPublished in: Journal of clinical medicine (2023)
In our systematic review, the majority of studies have very low-quality evidence and more RCTs are needed; furthermore, PTGBD is inferior in the treatment of AC in high-risk patients. The definition of high-risk patients is important in interpreting the results, but the methods of assessment and definitions differ between studies. The results of our systematic review and meta-analysis failed to demonstrate any advantage of using PTGBD over ER as a definitive treatment of AC in critically ill patients, which suggests that EC should be considered as the treatment of choice even in very high-risk patients. Most likely, the inferiority of PTGBD versus early LC for high-risk patients is related to an association of various patient-side factor conditions and the severity of acute cholecystitis.
Keyphrases
- end stage renal disease
- systematic review
- newly diagnosed
- ejection fraction
- chronic kidney disease
- prognostic factors
- peritoneal dialysis
- healthcare
- randomized controlled trial
- squamous cell carcinoma
- public health
- radiation therapy
- minimally invasive
- mass spectrometry
- patient reported
- smoking cessation
- decision making
- mechanical ventilation
- high resolution mass spectrometry