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A Multicenter Randomized Prospective Study of Early Cholecystectomy for Pediatric Patients with Biliary Colic

  • Original Article
  • Published:
Journal of Gastrointestinal Surgery

Abstract

Background

In patients with biliary colic, high-quality prospective data supporting the precise timing of cholecystectomy are lacking. The purpose of this study was to determine the effectiveness of early laparoscopic cholecystectomy in children with biliary colic.

Methods

A multicenter, parallel-group, randomized study was conducted in patients with biliary colic at 5 hospitals in China. Pediatric patients with biliary colic were prospectively randomized to either the early cholecystectomy or conservative management strategy. The clinical outcomes within 6 months, including the number of biliary colic-free patients and gallstone-related complications, were compared (register number ChiCTR1900021830).

Results

During the first 2 months of follow-up, 71 patients (59.2%, 71/120) receiving conservative management and 124 patients (97.6%, 124/127) in the early cholecystectomy group (p < 0.001) reported being entirely colic-free. The GIQLI measures were higher in the early cholecystectomy group than in the conservative management group (p = 0.032). Acute readmissions occurred in 7 (5.5%) of 127 patients in the early cholecystectomy group, compared with 23 (19.2%) of 120 patients in the conservative management group (risk ratio [RR] 0.25; 95% CI [0.10–0.60], p = 0.001) in the 6-month period.

Conclusions

Early cholecystectomy is effective in providing beneficial outcomes in terms of both short-term and long-term improvement of symptoms.

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Authors and Affiliations

  1. Department of Pediatric General Surgery and Liver Transplantation, Children’s Hospital, Chongqing Medical University, 136 Zhongshan 2nd Rd., Chongqing, 400014, People’s Republic of China

    Kai Gao, Huanli Han & Chunbao Guo

  2. Department of Orthopedics, Children’s Hospital, Chongqing Medical University, Chongqing, 400014, People’s Republic of China

    Chao Zheng

  3. Ministry of Education Key Laboratory of Child Development and Disorders, Children’s Hospital, Chongqing Medical University, Chongqing, People’s Republic of China

    Chunbao Guo

Authors
  1. Kai Gao
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  2. Chao Zheng
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  3. Huanli Han
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  4. Chunbao Guo
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Contributions

Kai Gao and Chao Zheng designed and evaluated the manuscript. Huanli Han performed the statistical measurements and analyzed the data. Chunbao Guo analyzed the data and wrote the paper.

Corresponding authors

Correspondence to Huanli Han or Chunbao Guo.

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Gao, K., Zheng, C., Han, H. et al. A Multicenter Randomized Prospective Study of Early Cholecystectomy for Pediatric Patients with Biliary Colic. J Gastrointest Surg 25, 713–719 (2021). https://doi.org/10.1007/s11605-020-04700-9

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  • DOI: https://doi.org/10.1007/s11605-020-04700-9

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