Surgical versus conservative management of delayed presentation of acute biliary disease : a systematic literature review

Show simplified metadata
dc.contributor.affiliationUniversity of Aleppo Medical College; University of Sharjah; Sandwell and West Birmingham NHS Trust; Dubai Health Care; et al.en_US
dc.contributor.authorKhalifa, Ahmad
dc.contributor.authorAllami, Sajad J
dc.contributor.authorOwais Tahhan
dc.contributor.authorAlhaj, Shaikha S
dc.contributor.authorAl Tahan, Mohamad A
dc.contributor.authorElnogoomi, Ibrahim
dc.contributor.departmentUrologyen_US
dc.contributor.roleMedical and Dentalen_US
dc.contributor.trustauthorTahhan, Owais
dc.date.accessioned2025-01-09T11:59:25Z
dc.date.available2025-01-09T11:59:25Z
dc.date.issued2024-11-22
dc.description.abstractBiliary sepsis, characterized by contamination and infection of the biliary tract, poses a serious medical issue with detrimental effects on the patients. While cholecystectomy is the usual treatment for symptomatic gallstones, the most desirable management approach for biliary sepsis remains debated, prompting a scientific evaluation of the long-term effects of cholecystectomy. To compare the long-term outcomes of biliary sepsis in patients undergoing cholecystectomy versus conservative management (CM), this study will systematically review the existing literature to clarify differences in recurrence rates, complication rates, and overall survival. PubMed and the Cochrane Library were searched thoroughly for the literature review. Studies were included if they reported the effects of surgical and conservative interventions on predefined patient outcomes. A critical appraisal of the studies included was performed using CASP criteria. Fourteen studies were included, comprising prospective cohort studies and randomized controlled trials, with sample sizes varying from 52 to 234 patients. Endoscopic sphincterotomy (ES), early versus delayed laparoscopic cholecystectomy (D-LC), combined endoscopic-laparoscopic techniques, and percutaneous cholecystostomy followed by early laparoscopic cholecystectomy (E-LC) were the analyzed interventions. The primary conclusions showed that, in comparison to D-LC, E-LC significantly reduced hospital stays (p < 0.05), since the times were 58 and 167 hours for E-LC and D-LC, respectively. Additionally, E-LC resulted in fewer recurrent biliary events (4.3 compared to 36.2% of D-LC) and lower overall costs. ES demonstrated efficacy in mitigating the requirement for emergency cholecystectomy in patients at high risk, as evidenced by its 94% success rate in endoscopic stone removal. Without increasing postoperative complications, combined endoscopic-laparoscopic techniques showed high success rates for stone removal (95.6% common bile duct clearance rate). This systematic review highlights the favorable long-term effects of cholecystectomy in managing biliary sepsis. It emphasizes the importance of individualized treatment processes and considers conservative control for patients with high surgical risk and significant comorbidities. It also highlights the need for advancement in CM and provides insights that can help clinical decision-making to optimize outcomes in affected patients.en_US
dc.identifier.citationKhalifa A, Allami SJ, Tahhan O, Alhaj SS, Al Tahan MA, Elnogoomi I. Surgical Versus Conservative Management of Delayed Presentation of Acute Biliary Disease: A Systematic Literature Review. Cureus. 2024 Nov 22;16(11):e74237. doi: 10.7759/cureus.74237en_US
dc.identifier.urihttp://hdl.handle.net/20.500.14200/6884
dc.language.isoenen_US
dc.publisherSpringeren_US
dc.source.journaltitleCureusen_US
dc.subjectSurgeryen_US
dc.titleSurgical versus conservative management of delayed presentation of acute biliary disease : a systematic literature reviewen_US
dc.typeArticleen_US
dspace.entity.typePublication
oa.grant.openaccessnaen_US
rioxxterms.versionNAen_US
Files
License bundle
Now showing 1 - 1 of 1
No Thumbnail Available
Name:
license.txt
Size:
1.7 KB
Format:
Item-specific license agreed upon to submission
Description:
Download
Collections
Research (Articles)