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Long-term Mortality and Intestinal Obstruction after Open Cholecystectomy: A Systematic Review and Meta-analysis

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Abstract

Long-term outcomes after open cholecystectomy are largely unknown. We aimed to investigate long-term mortality rate and incidence of intestinal obstruction after open cholecystectomy. Reporting of this systematic review and meta-analysis was according to the PRISMA 2020 guideline. A protocol was registered at PROSPERO (CRD42020178906). We searched the databases PubMed, Embase, and Cochrane CENTRAL in February 2022 for studies on long-term complications with n > 40 and follow-up ≥ 6 months. Outcomes included mortality and intestinal obstruction. Meta-analyses were conducted, and results were presented in forest plots. Risk of bias was assessed with the Newcastle–Ottawa Scale or Cochrane risk-of-bias tool 1. We included 21 studies. Long-term mortality after open cholecystectomy was reported in 17 studies including 125,222 patients, and it ranged from 0–35%. Follow-up ranged from six months to ten years. Meta-analysis estimated a long-term mortality rate of 9.2% (95% CI 6.8–11.6). One study with 90 patients reported on mini-laparotomy and none died during the 12 months follow-up. Three studies with 66,257 patients reported on intestinal obstruction after open cholecystectomy with an incidence ranging from 0.5% to 2.6%. Follow-up ranged from 36 to 67 months. Meta-analysis estimated a long-term rate of intestinal obstruction of 2.0% (95% CI 1.0–3.0). After a follow-up of six months to ten years, long-term mortality was 9.2%, and long-term incidence of intestinal obstruction was 2% up to 67 months after open cholecystectomy.

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Data Availability

Data extracted from the included studies can be shared upon request.

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Acknowledgements

We thank Kristoffer Andresen for his contribution to the conceptualization of the study.

Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

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Authors and Affiliations

  1. Center for Perioperative Optimization, Department of Surgery, Copenhagen University Hospital - Herlev and Gentofte, Borgmester Ib Juuls Vej 1, DK-2730, Herlev, Denmark

    Sofie Anne-Marie Skovbo Jensen, Siv Fonnes, Anders Gram-Hanssen & Jacob Rosenberg

  2. Department of Clinical Medicine, University of Copenhagen, Copenhagen Blegdamsvej 3B, DK-2200, Copenhagen, Denmark

    Jacob Rosenberg

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  1. Sofie Anne-Marie Skovbo Jensen
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  3. Anders Gram-Hanssen
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Contributions

All listed authors meet the ICMJE authorship criteria.

SASJ: Conceptualization; acquisition, analysis, and interpretation of the data; drafting the original draft; final approval; and agreed to be accountable for all aspects of the work.

SF: Conceptualization; interpretation of the data; critical revision of manuscript; final approval; and agreed to be accountable for all aspects of the work.

AG: Conceptualization; interpretation of the data; critical revision of manuscript; final approval; and agreed to be accountable for all aspects of the work.

JR: Conceptualization; interpretation of the data; critical revision of manuscript; final approval; and agreed to be accountable for all aspects of the work.

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Correspondence to Sofie Anne-Marie Skovbo Jensen.

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Jensen, S.AM.S., Fonnes, S., Gram-Hanssen, A. et al. Long-term Mortality and Intestinal Obstruction after Open Cholecystectomy: A Systematic Review and Meta-analysis. Indian J Surg (2024). https://doi.org/10.1007/s12262-024-04054-5

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