Laparoscopic Cholecystectomy or Conservative Treatment in the Acute Cholecystitis of Elderly Patients

NCT ID: NCT02972944

Last Updated: 2021-10-20

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

UNKNOWN

Clinical Phase

NA

Total Enrollment

200 participants

Study Classification

INTERVENTIONAL

Study Start Date

2016-10-31

Study Completion Date

2021-12-31

Brief Summary

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Cholecystectomy is the only curative treatment for gallstone disease of acute calculous cholecystitis.The purpose of this study is to find the most effective treatment (laparoscopic cholecystectomy vs. conservative) for elderly patients with acute cholecystitis. Therefore a randomized multi-centre study of 200 elderly patients suffering from acute cholecystitis is performed with additional cohort of all elderly patients with acute cholecystitis in the study hospitals during study period.

Detailed Description

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The increasing age is one of the main risk factors for developing complicated gallstone disease. Currently, there is lack of good quality studies comparing risks and benefits of early laparoscopic cholecystectomy in the elderly patients. Cholecystectomy is the only curative treatment for gallstone disease of acute calculous cholecystitis.

Aim: The purpose is to find out the most effective treatment (laparoscopic cholecystectomy vs. conservative) with the least morbidity for elderly patients with acute cholecystitis.

Study design: multicenter randomized controlled trial (RCT) and additional cohort of all elderly patients (\>75 years old) with acute cholecystitis.

Patient allocation: Elderly patients with diagnosis of acute cholecystitis will be randomly allocated to either early laparoscopic cholecystectomy or treatment with antibiotics. Reasonably healthy elderly patients (ASA 2-3) are included in this study, excluding the patients with ASA-class above 4.

Interventions: The study group of patients will undergo early laparoscopic cholecystectomy within 48 hours after hospitalization. The control group will be managed conservatively with intravenous antibiotics and elective cholecystectomy will not be scheduled later.

Primary outcome: Assessment of morbidities related to acute cholecystitis and individual quality of life. Secondary outcomes include number of hospital admissions, length of hospitalization, pain, complications, mortality and cost analysis.

Sample size and data-analysis: Based on data of previous studies the recruitment of 200 patients in total is expected. Follow-up will be for 12 months.

In addition of RCT, we decided to record and analyze all acute cholecystitis of elderly patients in study hospitals during the study period. We will present these results in the connection of RCT analysis.

Conditions

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Cholecystitis, Acute

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Cholecystectomy group

Cholecystectomy group will undergo laparoscopic cholecystectomy within 48 hrs after randomization.

Group Type EXPERIMENTAL

Laparoscopic cholecystectomy

Intervention Type PROCEDURE

Non-operative group

Patients of non-operative group will be treated conservatively with intravenous antibiotics (cefuroxime) at surgical ward. Elective cholecystectomy will not be arranged.

Group Type ACTIVE_COMPARATOR

Non-operative treatment

Intervention Type PROCEDURE

Interventions

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Laparoscopic cholecystectomy

Intervention Type PROCEDURE

Non-operative treatment

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

* Radiologically confirmed acute cholecystitis
* Age over 75 yrs
* American Association of Anesthesiologists Classification class 2-3
* Duration of symptoms \< 5 days

Exclusion Criteria

* American Association of Anesthesiologists Classification class 4-5
* Age under 75 yrs
* Peritonitis
* Sepsis or septic shock
* Duration of symptoms over 6 days
* Cholestasis or diagnosed stone at common biliary duct.
* Acute Pancreatitis
Minimum Eligible Age

75 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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Turku University Hospital

OTHER_GOV

Sponsor Role collaborator

Tampere University Hospital

OTHER

Sponsor Role collaborator

Oulu University Hospital

OTHER

Sponsor Role collaborator

Mikkeli Central Hospital

OTHER

Sponsor Role collaborator

North Karelia Central Hospital

OTHER

Sponsor Role collaborator

Jyväskylä Central Hospital

OTHER

Sponsor Role collaborator

Päijänne Tavastia Central Hospital

OTHER

Sponsor Role collaborator

Central Hospital of Hämeenlinna

UNKNOWN

Sponsor Role collaborator

Central Hospital of Jorvi

UNKNOWN

Sponsor Role collaborator

Kuopio University Hospital

OTHER

Sponsor Role lead

Responsible Party

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Hannu Paajanen

Professor

Responsibility Role PRINCIPAL_INVESTIGATOR

Locations

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Kuopio University Hospital

Kuopio, Northern Savonia, Finland

Site Status RECRUITING

Countries

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Finland

Central Contacts

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Hannu Paajanen, Professor

Role: CONTACT

17 173 311 ext. +358

Antti Kivivuori, MD

Role: CONTACT

443516698 ext. +358

Facility Contacts

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Tuomo Rantanen, Professor

Role: primary

17 173 311 ext. +358

Other Identifiers

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326/2016

Identifier Type: -

Identifier Source: org_study_id