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Percutaneous cholecystostomy versus emergency cholecystectomy for the treatment of acute calculous cholecystitis in high-risk surgical patients: a meta-analysis and systematic review

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Abstract

The present meta-analysis was performed to compare the efficacy and safety of percutaneous cholecystostomy (PC) versus emergency cholecystectomy (EC) for the treatment of acute calculous cholecystitis (ACC) in high-risk surgical patients. Literature searches for eligible studies were performed using MEDLINE, EMBASE and the Cochrane Library. Quality assessment was conducted in each study. Meta-analyses were performed to demonstrate the pooled effects of relative risk (RR) with 95% confidence intervals (CI). A total of 8960 patients from 6 studies were finally included. PC resulted in increased risks of mortality (RR = 2.87; CI = 1.33–6.18; p = 0.007) and readmission rate (RR = 4.70; CI = 3.30–6.70; p < 0.00001) as compared with EC. No significant difference was detected between PC and EC in terms of morbidity, severe complication rate or hospitalization length. Moreover, PC was associated with significantly higher risks of mortality (RR = 7.47; CI = 1.88–29.72; p = 0.004), morbidity (RR = 3.71; 95% CI = 1.78–7.75; p = 0.0005), readmission rate (RR = 7.91; CI = 3.80–16.49; p < 0.00001), and hospitalization length (WMD = 6.92; CI = 5.89–7.95; p < 0.00001) when directly compared with laparoscopic cholecystectomy (LC). Therefore, EC is superior to PC for the treatment of ACC in high-risk surgical patients, and LC is the preferred surgical strategy.

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Funding

This study was supported by grants from the National Natural Science Foundation of China (81773049, 81402359, 81602617).

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  1. Hejing Huang, Hang Zhang and Dejun Yang contributed equally to this work.

Authors and Affiliations

  1. Department of Ultrasound, Changzheng Hospital, Naval Medical University, Shanghai, China

    Hejing Huang & Hang Zhang

  2. Department of Gastrointestinal Surgery, Changzheng Hospital, Naval Medical University, Shanghai, China

    Dejun Yang, Weijun Wang & Xin Zhang

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  1. Hejing Huang
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Huang, H., Zhang, H., Yang, D. et al. Percutaneous cholecystostomy versus emergency cholecystectomy for the treatment of acute calculous cholecystitis in high-risk surgical patients: a meta-analysis and systematic review. Updates Surg 74, 55–64 (2022). https://doi.org/10.1007/s13304-021-01081-9

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