1 Jan 2021Article
Does surgical experience really matter on the treatment approach to acute cholecystitis. A randomised clinical trial
Riza Isil 1Pinar Yazici 2Canan Isil 3Mehmet Mihmanli 2
Affiliations
Article Info
1 Sisli Okmeydani Education and Research Hospital, General Surgery Clinic, Darulacize, Sisli, Istanbul, Turkey
2 Hamidiye Etfal Education and Research Hospital, General Surgery Clinic, Halaskargazi, Sisli, Istanbul, Turkey
3 Asklepios Klinikum Harburg Hospital, Specialist, Anesthesiology and Reanimation Clinic, Hamburg, Germany
Ann. Ital. Chir., 2021, 92(1), 28-34;
Published: 1 Jan 2021
Copyright © 2021 Annali Italiani di Chirurgia
This work is licensed under a Creative Commons Attribution 4.0 International License.
Abstract
AIM: Experienced surgeons usually prefer early laparoscopic cholecystectomy (ELC) instead of delayed laparoscopic cholecystectomy (DLC) for the treatment of acute cholecystitis (AC). However, the question remains, if ELC is also safe for beginner surgeons. This study compares ELC versus DLC for the treatment of AC as a beginner surgeon approach. MATERIAL AND METHODS: In this prospective randomized clinical trial, patients suffering AC in their first 72 hours of pain were enrolled either in Group L (n:88); patients were treated surgically with ELC immediately or Group D (n:88); patients were first treated medically and than treated surgically with DLC 4-8 weeks later. All operations and medical treatments were done by the same beginner surgeon. RESULTS: In Group L operation time was 60 (50-65) minutes, total hospital stay was 1.5 (1-7) days and total cost was 337.38±78.46 (287-827) USD. In Group D operation time was 50.5 (45-60) minutes, total hospital stay was 5.5(3-15) days and total cost was 499.29±199.38 (321-1506) USD. There were no significant differences regarding to the complications (p>0.05). Hospital stay and total costs were significantly higher in Group D (p<0.001). CONCLUSIONS: This study indicates, that ELC can definitely be chosen as a treatment approach for AC even by beginner surgeons, considering that it reduces hospital stay and total cost.
Keywords
- Acute Cholecystitis
- Delayed laparoscopic cholecystectomy
- Early laparoscopic cholecystectomy
- Surgical work experience