The Real World of Acute Cholecystitis

NCT ID: NCT02796443

Last Updated: 2019-07-26

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Total Enrollment

1729 participants

Study Classification

OBSERVATIONAL

Study Start Date

2006-01-31

Study Completion Date

2016-05-31

Brief Summary

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Meta-analysis of randomized controlled trials and population based studies in acute cholecystitis are in favor for early laparoscopic surgery versus a delayed operation several weeks later. The main problems in these studies are the exclusion criteria used, thus not reflecting the real world setting of acute cholecystitis. The purpose of this study is to demonstrate that a delayed laparoscopic cholecystectomy in a real world scenario has no worse outcome in comparison with an early operation (within 72 hours after onset of symptoms).

Detailed Description

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Background:

Randomized controlled trials (RCTs) and population based studies are in favor of an early operation in acute cholecystitis (1, 2). Thus, one of the largest RCT so far, demonstrated significant more complications in a group of delayed cholecystectomy. The main problems in these studies are the exclusion criteria used, ie severe cases are not considered.

Objective:

In a cohort study all cholecystectomy patients are analysed to demonstrate that delayed laparoscopic cholecystectomy (DLC) in a real world setting has a less complication rate than early cholecystectomy (ELC).

Setting:

Academic Teaching Hospital with 400 beds, seven departments (anesthesiology and intensive care medicine, orthopaedics and trauma surgery, visceral and thoracic surgery, gastroenterology, cardiology, gynecology and obstetrics, psychiatry. The visceral and thoracic department has a main focus on minimally invasive techniques.

Participants:

All cholecystectomy patients during 1/2006 and 9/2015

Variables:

Clavien Dindo Complication score, American Society of Anaesthesiologist (ASA) Score, conversion rate, onset of symptoms, histology, hospital stay

Data sources:

Chart analyses

Conditions

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Acute Cholecystitis

Study Design

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Observational Model Type

COHORT

Study Time Perspective

RETROSPECTIVE

Study Groups

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Early laparoscopic cholecystectomy (ELC)

Operation within 72 hours after onset of symptoms

Laparoscopic cholecystectomy (LC)

Intervention Type PROCEDURE

Removal of the gallbladder via a minimally invasive approach

Intermediate cholecystectomy (ILC)

Operation within 14 days after onset of symptoms

Laparoscopic cholecystectomy (LC)

Intervention Type PROCEDURE

Removal of the gallbladder via a minimally invasive approach

Delayed LC (DLC)

Operation after 6-12 weeks

Laparoscopic cholecystectomy (LC)

Intervention Type PROCEDURE

Removal of the gallbladder via a minimally invasive approach

Elective laparoscopic cholecystectomy

Biliary colic with no acute cholecystitis

Laparoscopic cholecystectomy (LC)

Intervention Type PROCEDURE

Removal of the gallbladder via a minimally invasive approach

Interventions

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Laparoscopic cholecystectomy (LC)

Removal of the gallbladder via a minimally invasive approach

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

* All patients with cholecystectomies
Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Goethe University

OTHER

Sponsor Role collaborator

Asklepios Klinik Langen

OTHER

Sponsor Role lead

Responsible Party

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Prof. Dr. Dr. Ernst Hanisch

Prof. Dr. Dr.

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Ernst W Hanisch, Prof Dr Dr

Role: PRINCIPAL_INVESTIGATOR

Asklepios Klinik Langen

References

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Gutt CN, Encke J, Koninger J, Harnoss JC, Weigand K, Kipfmuller K, Schunter O, Gotze T, Golling MT, Menges M, Klar E, Feilhauer K, Zoller WG, Ridwelski K, Ackmann S, Baron A, Schon MR, Seitz HK, Daniel D, Stremmel W, Buchler MW. Acute cholecystitis: early versus delayed cholecystectomy, a multicenter randomized trial (ACDC study, NCT00447304). Ann Surg. 2013 Sep;258(3):385-93. doi: 10.1097/SLA.0b013e3182a1599b.

Reference Type BACKGROUND
PMID: 24022431 (View on PubMed)

de Mestral C, Rotstein OD, Laupacis A, Hoch JS, Zagorski B, Alali AS, Nathens AB. Comparative operative outcomes of early and delayed cholecystectomy for acute cholecystitis: a population-based propensity score analysis. Ann Surg. 2014 Jan;259(1):10-5. doi: 10.1097/SLA.0b013e3182a5cf36.

Reference Type BACKGROUND
PMID: 23979286 (View on PubMed)

Other Identifiers

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AKLangen

Identifier Type: -

Identifier Source: org_study_id

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