Early Versus Delayed Cholecystectomy
2017年4月23日 更新者：Canan Tulay ISIL、Sisli Hamidiye Etfal Training and Research Hospital
Should Surgical Experience Change Our Treatment Strategy on Acute Cholecystitis? Early Versus Delayed Cholecystectomy
This study examines complications, mortality rates, cost-effectiveness and safety of early laparoscopic cholecystectomy (ELC) versus delayed laparoscopic cholecystectomy (DLC).
Group L (n:88) patients treated surgically with laparoscopic cholecystectomy immediately or Group D (n:88) patients first treated medically and than treated surgically with delayed (4-8 weeks later) laparoscopic cholecystectomy.
研究概览
详细说明
There is only few knowledge about the comparison of early laparoscopic cholecystectomy (ELC) versus delayed laparoscopic cholecystectomy (DLC) for the treatment of acute cholecystitis considering the surgeon's work experience.
This study examines complications, mortality rates, cost-effectiveness and safety of DLC versus ELC.
This prospective randomized clinical trial was performed between November 2015-2016 in our General Surgery Clinic.
Patients suffering acute cholecystitis in their first 72 hours of pain were enrolled in one of the two study groups: Group L (n:88) patients treated surgically with laparoscopic cholecystectomy immediately or Group D (n:88) patients first treated medically and than treated surgically with delayed (4-8 weeks later) laparoscopic cholecystectomy.
All operations and medical treatments were done by surgeons having work experience <2 years.
研究类型
介入性
注册 (实际的)
176
阶段
- 不适用
参与标准
研究人员寻找符合特定描述的人，称为资格标准。这些标准的一些例子是一个人的一般健康状况或先前的治疗。
资格标准
适合学习的年龄
18年 至 65年 (成人、年长者)
接受健康志愿者
不
有资格学习的性别
全部
描述
Inclusion Criteria:
- patients suffering acute cholecystitis in their first 72 hours of pain
Exclusion Criteria:
- clinical duration longer than 72 hours, complicated acute cholecystitis (bilirubin >2gr/dl, elevated transaminases (>100 u/l), and cholestatic enzymes (gamma glutamyl transferase >50 u/l), ultrasonographically confirmed dilated intrahepatic or extrahepatic bile ducts, and elevated amylase levels three times more than normal range
学习计划
本节提供研究计划的详细信息，包括研究的设计方式和研究的衡量标准。
研究是如何设计的？
设计细节
- 主要用途：治疗
- 分配：随机化
- 介入模型：并行分配
- 屏蔽：无（打开标签）
武器和干预
参与者组/臂 |
干预/治疗 |
|---|---|
|
其他：Group L (n:88)
patients treated surgically with laparoscopic cholecystectomy immediately
|
First trocar was inserted with Hasson method (Subumbilical 1 cm vertical incision was made and first 10-mm trocar (VersaportTM plus V2, Covidien, USA) inserted under direct vision) and pneumoperitoneum was created with 12 mm Hg pressure.
Second 10-mm trocar was inserted from subxyphoid area.
Two 5-mm trocars were inserted in the right upper quadrant area.
After general intrabdominal exploration, dissection was started to ensure safe-view of Calot triangle.
In case of quite tough gallbladder for griping, gallbladder was drained with a gray intravenous cannula.
Cystic artery and cystic duct were separately dissected and twice ligated with Endo Clip™ II ML (Covidien, USA).
Gallbladder was dissected from liver bed carefully.
Gallbladder was taken out from abdomen through the subumbilical incision.
|
|
其他：Group D (n:88)
patients first treated medically and than treated surgically with delayed (4-8 weeks later) laparoscopic cholecystectomy
|
First trocar was inserted with Hasson method (Subumbilical 1 cm vertical incision was made and first 10-mm trocar (VersaportTM plus V2, Covidien, USA) inserted under direct vision) and pneumoperitoneum was created with 12 mm Hg pressure.
Second 10-mm trocar was inserted from subxyphoid area.
Two 5-mm trocars were inserted in the right upper quadrant area.
After general intrabdominal exploration, dissection was started to ensure safe-view of Calot triangle.
In case of quite tough gallbladder for griping, gallbladder was drained with a gray intravenous cannula.
Cystic artery and cystic duct were separately dissected and twice ligated with Endo Clip™ II ML (Covidien, USA).
Gallbladder was dissected from liver bed carefully.
Gallbladder was taken out from abdomen through the subumbilical incision.
|
研究衡量的是什么？
主要结果指标
结果测量 |
措施说明 |
大体时间 |
|---|---|---|
|
Hospital stay
大体时间：4 to 8 weeks
|
time spent totally in the hospital; time from admission to discharge from hospital in days
|
4 to 8 weeks
|
次要结果测量
结果测量 |
措施说明 |
大体时间 |
|---|---|---|
|
Costs of treatment
大体时间：4 to 8 weeks
|
costs of treatment spent for surgery and hospital stay in days; costs of treatment from admission to discharge from hospital in USD
|
4 to 8 weeks
|
合作者和调查者
在这里您可以找到参与这项研究的人员和组织。
调查人员
- 首席研究员：Riza Gurhan Isil, MD、Sağlık Bilimleri Üniversitesi Şişli Hamidiye Etfal Eğitim ve Araştırma Hastanesi
出版物和有用的链接
负责输入研究信息的人员自愿提供这些出版物。这些可能与研究有关。
一般刊物
- Stinton LM, Shaffer EA. Epidemiology of gallbladder disease: cholelithiasis and cancer. Gut Liver. 2012 Apr;6(2):172-87. doi: 10.5009/gnl.2012.6.2.172. Epub 2012 Apr 17.
- Gurusamy K, Samraj K, Gluud C, Wilson E, Davidson BR. Meta-analysis of randomized controlled trials on the safety and effectiveness of early versus delayed laparoscopic cholecystectomy for acute cholecystitis. Br J Surg. 2010 Feb;97(2):141-50. doi: 10.1002/bjs.6870. Erratum In: Br J Surg. 2010 Apr;97(4):624.
研究记录日期
这些日期跟踪向 ClinicalTrials.gov 提交研究记录和摘要结果的进度。研究记录和报告的结果由国家医学图书馆 (NLM) 审查，以确保它们在发布到公共网站之前符合特定的质量控制标准。
研究主要日期
学习开始 (实际的)
2015年11月1日
初级完成 (实际的)
2016年11月1日
研究完成 (实际的)
2017年2月15日
研究注册日期
首次提交
2017年3月28日
首先提交符合 QC 标准的
2017年4月17日
首次发布 (实际的)
2017年4月20日
研究记录更新
最后更新发布 (实际的)
2017年4月25日
上次提交的符合 QC 标准的更新
2017年4月23日
最后验证
2017年4月1日
更多信息
与本研究相关的术语
其他研究编号
- SHEEAH 12.04.2016/1141
计划个人参与者数据 (IPD)
计划共享个人参与者数据 (IPD)？
不
IPD 计划说明
I can share study data only without sharing patient names and protocol numbers.
药物和器械信息、研究文件
研究美国 FDA 监管的药品
不
研究美国 FDA 监管的设备产品
不
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