Timing of Cholecystectomy After Moderate and Severe Acute Biliary Pancreatitis-Reference-Cited by-同舟云学术

Timing of Cholecystectomy After Moderate and Severe Acute Biliary Pancreatitis

Published:2023-10-11 Issue:10 Volume:158 Page:e233660
ISSN:2168-6254
Container-title:JAMA Surgery
language:en
Short-container-title:JAMA Surg

Author:

Di Martino Marcello¹,Ielpo Benedetto²,Pata Francesco³⁴,Pellino Gianluca⁵⁶,Di Saverio Salomone⁷,Catena Fausto⁸,De Simone Belinda⁹,Coccolini Federico¹⁰,Sartelli Massimo¹¹,Damaskos Dimitrios¹²,Mole Damian¹³,Murzi Valentina¹⁴,Leppaniemi Ari¹⁵,Pisanu Adolfo¹⁴,Podda Mauro¹⁴,Gerardi Chiara¹⁶,Virdis Francesco¹⁶,Pacella Daniela¹⁶,Jayant Kumar¹⁶,Agresta Ferdinando¹⁶,Riboni Cristiana¹⁶,Kluger Yoram¹⁶,de Santibañes Martin¹⁶,Di Menno Stavron Juliana¹⁶,Mazza Oscar¹⁶,Valenzuela José I¹⁶,Pachajoa Diana AP¹⁶,Alvarez Fernando A¹⁶,Liaño Julian E¹⁶,Gundara Justin¹⁶,Tefay Joan¹⁶,Alawadhi Kamel¹⁶,Alshaikh Abdulrahman¹⁶,Hasan Layla¹⁶,Gomes Carlos A¹⁶,Gomes Felipe C¹⁶,Fraga Gustavo P¹⁶,Calderan Thiago RA¹⁶,Hirano Elcio S¹⁶,Dardanov Dragomir¹⁶,Julianov Alexander¹⁶,Saroglu Azize¹⁶,Atanasov Boyko¹⁶,Belev Nikolay¹⁶,Kovachev Nikola¹⁶,Lui Rashid¹⁶,Chan Shannon M¹⁶,Lok Hon-Ting¹⁶,Salcedo Diego¹⁶,Robayo Diana¹⁶,Triviño Maria A¹⁶,Manak Jan¹⁶,Sahani Saaz¹⁶,de Araujo Jorann¹⁶,Sethi Ananya¹⁶,Awad Ahmed¹⁶,Elbadawy Merihan¹⁶,Farid Ahmed¹⁶,Hanafy Asmaa¹⁶,Nafea Ahmed¹⁶,Ghozy Sherief¹⁶,Salah–Abbas Alzhraa¹⁶,Abdelsalam Wafaa¹⁶,Emile Sameh¹⁶,Elfallal Ahmed¹⁶,Elfeki Hossam¹⁶,Elghadban Hosam¹⁶,Shoma Ashraf¹⁶,Shetiwy Mohamed¹⁶,Elbahnasawy Mohamed¹⁶,Mohamed Salem¹⁶,Hamed Emad F¹⁶,Khalil Usama A¹⁶,Chouillard Elie¹⁶,Gumbs Andrew¹⁶,Police Andréa¹⁶,Mabilia Andrea¹⁶,Demetrashvili Zaza¹⁶,Khutsishvili Kakhi¹⁶,Tvaladze Anano¹⁶,Ioannidis Orestis¹⁶,Anestiadou Elissavet¹⁶,Loutzidou Lydia¹⁶,Ioannidis Argyrios¹⁶,Konstantinidis Konstantinis¹⁶,Konstantinidou Sofia¹⁶,Manatakis Dimitrios¹⁶,Acheimastos Vasileios¹⁶,Tasis Nikolaos¹⁶,Michalopoulos Nikolaos¹⁶,Kokoropoulos Panagiotis¹⁶,Papadoliopoulou Maria¹⁶,Sotiropoulou Maria¹⁶,Kapiris Stylianos¹⁶,Metaxas Panagiotis¹⁶,Tsouknidas Ioannis¹⁶,Kefili Despoina¹⁶,Petrakis George¹⁶,Synekidou Eirini¹⁶,Dakis Konstantinos¹⁶,Alexandridou Eirini¹⁶,Papadopoulos Aristeidis¹⁶,Chouliaras Christos¹⁶,Mouzakis Odysseas¹⁶,Mulita Francesk¹⁶,Maroulis Ioannis¹⁶,Vailas Michail¹⁶,Triantafyllou Tania¹⁶,Theodorou Dimitrios¹⁶,Lostoridis Eftychios¹⁶,Nagorni Eleni A¹⁶,Tourountzi Paraskevi¹⁶,Baili Efstratia¹⁶,Charalabopoulos Alexandros¹⁶,Liakakos Theodore¹⁶,Schizas Dimitrios¹⁶,Kozadinos Alexandros¹⁶,Syllaios Athanasios¹⁶,Machairas Nikolaos¹⁶,Kykalos Stylianos¹⁶,Stamopoulos Paraskevas¹⁶,Delis Spiros¹⁶,Farazi-Chongouki Christos¹⁶,Kalaitzakis Evangelos¹⁶,Giannarakis Miltiadis¹⁶,Lasithiotakis Konstantinos¹⁶,Petra Giorgia¹⁶,Ralon Sergio¹⁶,Gupta Amit¹⁶,Medappil Noushif¹⁶,Muthukrishnan Vijayanand¹⁶,Kamar Jubin¹⁶,Bains Lovenish¹⁶,Lal Pawan¹⁶,Agarwal Rajendra¹⁶,Magnoli Matteo¹⁶,Aonzo Paolo¹⁶,Serventi Alberto¹⁶,Giuliani Antonio¹⁶,Di Lascio Pierpaolo¹⁶,Pinto Margherita¹⁶,Bergamini Carlo¹⁶,Bottari Andrea¹⁶,Fortuna Laura¹⁶,Martellucci Jacopo¹⁶,Cicako Atea¹⁶,Miglietta Claudio¹⁶,Morino Mario¹⁶,Delogu Daniele¹⁶,Picchetto Andrea¹⁶,Assenza Marco¹⁶,D'Ambrosio Giancarlo¹⁶,Argenio Giulio¹⁶,Ioia Giovanna¹⁶,Armellino Mariano F¹⁶,Occhionorelli Savino¹⁶,Lacavalla Domenico¹⁶,Andreotti Dario¹⁶,Luppi Davide¹⁶,Casadei Massimiliano¹⁶,Di Donato Luca¹⁶,Manoochehri Farshad¹⁶,Marchese Tiziana RL¹⁶,Sergi William¹⁶,Manca Roberto¹⁶,Murgia Raimondo¹⁶,Piras Enrico¹⁶,Conti Lorenzo¹⁶,Gianazza Simone¹⁶,Rizzi Andrea¹⁶,Segalini Edoardo¹⁶,Monti Marco¹⁶,Liritano Elena¹⁶,Mariani Nicolò M¹⁶,De Nicola Enrico¹⁶,Scifo Giovanna¹⁶,Pignata Giusto¹⁶,Andreuccetti Jacopo¹⁶,Fleres Francesco¹⁶,Clarizia Guglielmo¹⁶,Spolini Alessandro¹⁶,Biloslavo Alan¹⁶,Germani Paola¹⁶,Mastronardi Manuela¹⁶,Bogoni Selene¹⁶,Palmisano Silvia¹⁶,De Manzini Nicolò¹⁶,Marino Marco V¹⁶,Poillucci Gaetano¹⁶,Martines Gennaro¹⁶,Trigiante Giuseppe¹⁶,Lagouvardou Elpiniki¹⁶,Anania Gabriele¹⁶,Bombardini Cristina¹⁶,Oppici Dario¹⁶,Pilia Tiziana¹⁶,Murzi Valentina¹⁶,Gessa Emanuela¹⁶,Locci Eleonora¹⁶,Bracale Umberto¹⁶,Di Nuzzo Maria M¹⁶,Peltrini Roberto¹⁶,Ansaloni Luca¹⁶,Salvetti Francesco¹⁶,Viganò Jacopo¹⁶,Sganga Gabriele¹⁶,Bianchi Valentina¹⁶,Fransvea Pietro¹⁶,Fontana Tommaso¹⁶,Sarro Giuliano¹⁶,Dinuzzi Vincenza P¹⁶,Scaravilli Luca¹⁶,Papa Mario V¹⁶,Jovine Elio¹⁶,Ciabatti Giulia¹⁶,Mastrangelo Laura¹⁶,Rottoli Matteo¹⁶,Ricci Claudio¹⁶,Russo Iris S¹⁶,Aiolfi Alberto¹⁶,Bona Davide¹⁶,Lombardo Francesca¹⁶,Cianci Pasquale¹⁶,Sederino Mariagrazia¹⁶,Bini Roberto¹⁶,Chiara Osvaldo¹⁶,Cioffi Stefano PB¹⁶,Giordano Alessio¹⁶,Cantafio Stefano¹⁶,Coretti Guido¹⁶,Licitra Edelweiss¹⁶,Savino Grazia¹⁶,Grimaldi Sergio¹⁶,Porfidia Raffaele¹⁶,Moggia Elisabetta¹⁶,Garino Mauro¹⁶,Marafante Chiara¹⁶,Pesce Antonio¹⁶,Fabbri Nicolò¹⁶,Feo Carlo V¹⁶,Marra Ester¹⁶,Nagliati Carlo¹⁶,Troian Marina¹⁶,Drigo Davide¹⁶,Muratore Andrea¹⁶,Danna Riccardo¹⁶,Murgese Alessandra¹⁶,Crespi Michele¹⁶,Ferrario Luca¹⁶,Guerci Claudio¹⁶,Frontali Alice¹⁶,Ferrari Luca¹⁶,Favi Francesco¹⁶,Picariello Erika¹⁶,Rampini Alessia¹⁶,D'Acapito Fabrizio¹⁶,Ercolani Giorgio¹⁶,Solaini Leonardo¹⁶,Palmieri Francesco¹⁶,Calì Matteo¹⁶,Ferrara Francesco¹⁶,Muttillo Irnerio A¹⁶,Muttillo Edoardo M¹⁶,Picardi Biagio¹⁶,Galleano Raffaele¹⁶,Badran Ali¹⁶,Ghazouani Omar¹⁶,Cervellera Maurizio¹⁶,Campanella Gaetano¹⁶,Papa Gennaro¹⁶,Di Bella Annamaria¹⁶,Perrone Gennaro¹⁶,Petracca Gabriele L¹⁶,Prioriello Concetta¹⁶,Giuffrida Mario¹⁶,Cozzani Federico¹⁶,Rossini Matteo¹⁶,Inama Marco¹⁶,Butturini Giovanni¹⁶,Moretto Gianluigi¹⁶,Morelli Luca¹⁶,Di Candio Giulio¹⁶,Guadagni Simone¹⁶,Cicuttin Enrico¹⁶,Cremonini Camilla¹⁶,Tartaglia Dario¹⁶,Genovese Valerio¹⁶,Chiarugi Massimo¹⁶,Cillara Nicola¹⁶,Cannavera Alessandro¹⁶,Deserra Antonello¹⁶,Picciariello Arcangelo¹⁶,Papagni Vincenzo¹⁶,Vincenti Leonardo¹⁶,Bagaglini Giulia¹⁶,Sica Giuseppe¹⁶,Lapolla Pierfrancesco¹⁶,Brachini Gioia¹⁶,Mingoli Andrea¹⁶,Bono Dario¹⁶,Nicotera Antonella¹⁶,Zago Marcello¹⁶,Sammartano Fabrizio¹⁶,Benuzzi Laura¹⁶,Stella Marco¹⁶,Rossi Stefano¹⁶,Cerioli Alessandra¹⁶,Puccioni Caterina¹⁶,Olmi Stefano¹⁶,Rubicondo Carolina¹⁶,Uccelli Matteo¹⁶,Balla Andrea¹⁶,Guida Anna¹⁶,Lepiane Pasquale¹⁶,Sasia Diego¹⁶,Giraudo Giorgio¹⁶,Salomone Sara¹⁶,Nigri Giuseppe¹⁶,Belloni Elena¹⁶,Cossa Alessandra¹⁶,Lancellotti Francesco¹⁶,Caronna Roberto¹⁶,Chirletti Piero¹⁶,Saullo Paolina¹⁶,Troiano Raffaele¹⁶,Mucilli Felice¹⁶,Barone Mirko¹⁶,Ippoliti Massimo¹⁶,Grande Michele¹⁶,Sensi Bruno¹⁶,Siragusa Leandro¹⁶,Ortenzi Monica¹⁶,Santini Andrea¹⁶,Veroux Gastone¹⁶,Di Carlo Isidoro¹⁶,Gioco Rossella¹⁶,Veroux Massimiliano¹⁶,Currò Giuseppe¹⁶,Ammendola Michele¹⁶,Komaei Iman¹⁶,Navarra Giuseppe¹⁶,Tonini Valeria¹⁶,Sartarelli Lodovico¹⁶,Vaccari Samuele¹⁶,Ceresoli Marco¹⁶,Perrone Stefano¹⁶,Roccamatisi Linda¹⁶,Millo Paolo¹⁶,Brachet-Contul Riccardo¹⁶,Ponte Elisa¹⁶,Zuin Matteo¹⁶,Portale Giuseppe¹⁶,Tonello Alice S¹⁶,Fratini Geri¹⁶,Bianchini Matteo¹⁶,Perotti Bruno¹⁶,Doria Emanuele¹⁶,Lunghi Elia G¹⁶,Visconti Diego¹⁶,Khamees Almu'atasim¹⁶,Al-Shami Khayry¹⁶,Awadi Sajeda¹⁶,Ababneh Hazim¹⁶,Buwaitel Mohammad MK¹⁶,Naffa' Mo'taz FN¹⁶,Aljaiuossi Osama¹⁶,Samhouri Ahmad¹⁶,Sawalha Hatem¹⁶,Yusoff Ahmad R¹⁶,Che Ani Mohd F¹⁶,Fathil Ida NA¹⁶,Huei Jih¹⁶,Mohamad Ikhwan S¹⁶,Zakaria Andee D¹⁶,Ya'acob Mohammad Z¹⁶,Beristain-Hernandez Jose L¹⁶,Garcia-Meza Alejandro¹⁶,Sepulveda-Rodriguez Rafael¹⁶,Lozada Hernández Edgard E¹⁶,Acuña Pinzón Camilo L¹⁶,Condoy Jefferson N¹⁶,Becerra García Francisco C¹⁶,Pimentel Samuel¹⁶,Garzali Ibrahim U¹⁶,Sadik Mohammad¹⁶,Kadir Bushra¹⁶,Devi Jalpa¹⁶,Seerani Nandlal¹⁶,Sohail- Asghar Mohammad¹⁶,Afzal Ameer¹⁶,Akbar Ali¹⁶,Machain Gustavo M¹⁶,Segovia Lohse Helmut¹⁶,Segovia Lohse Herald¹⁶,Quispe-Cruz Darwin A¹⁶,Cabrera Zamiara SL¹⁶,Yamamoto Seto Gaby S¹⁶,Chiuyari José R¹⁶,Ordemar Jorge¹⁶,Rodríguez Martha¹⁶,Orantia-Carlos Abigail CC¹⁶,Quitoy Margie A¹⁶,Walędziak Maciej¹⁶,Kwiatkowski Andrzej¹⁶,Mawlichanów Maciej¹⁶,Correia de Sá Tiago¹⁶,Rocha Mónica¹⁶,Soares Carlos¹⁶,Muhammad Ali Syed¹⁶,Stoian Alexandru R¹⁶,Draghici Andreea D¹⁶,Grigorean Valentin T¹⁶,Calu Valentin¹⁶,Radulescu Raluca B¹⁶,Zarnescu Narcis O¹⁶,Costea Radu V¹⁶,Zarnescu Eugenia C¹⁶,Litvin Andrey¹⁶,Kurtenkov Mikhail¹⁶,Gendrikson George¹⁶,Alla-Angelina Volovich¹⁶,Tsurbanova Arina¹⁶,Kaldarov Ayrat¹⁶,Gachabayov Mahir¹⁶,Abdullaev Abakar¹⁶,Kovacevic Bojan¹⁶,Milentijevic Milica¹⁶,Karamarkovic Milovan¹⁶,Panyko Arpád¹⁶,Lesko Dusan¹⁶,Radonak Jozef¹⁶,Soltes Marek¹⁶,Noel Colin¹⁶,Abdalah Haidar M¹⁶,Hamid Hytham KS¹⁶,Roesel Raffaello¹⁶,Cristaudi Alessandra¹⁶,Hamdan Alaa¹⁶,Abbas Kinan¹⁶,Ali Iyad¹⁶,Kchaou Ali¹⁶,Tlili Ahmed¹⁶,Isik Arda¹⁶,Bayhan Hüseyin¹⁶,Türkoğlu Mehmet A¹⁶,Uzunoglu Mustafa Y¹⁶,Azamat Ibrahim F¹⁶,Omarov Nail¹⁶,Uymaz Derya S¹⁶,Altintoprak Fatih¹⁶,Akin Emrah¹⁶,First Necattin¹⁶,Das Koray¹⁶,Ozer Nazmi¹⁶,Seker Ahmet¹⁶,Kara Yasin¹⁶,Bozkurt Mehmet A¹⁶,Kocataş Ali¹⁶,Atici Semra D¹⁶,Akalin Murat¹⁶,Calik Bulent¹⁶,Colak Elif¹⁶,Altinel Yuksel¹⁶,Meric Serhat¹⁶,Aktimur Yunus E¹⁶,Chooklin Serge¹⁶,Chuklin Serhii¹⁶,Bilyak Andriy¹⁶,Bonilla Cal Fernando¹⁶,Sánchez Lianet¹⁶,Domínguez Fabiana¹⁶,Meead Abdullah¹⁶,Al-Raimi Ibrahim¹⁶,Alshargabi Haneen¹⁶,Hudson Victoria¹⁶,Duval Jean-Luc¹⁶,Gourgiotis Stavros¹⁶,Khan Mansoor¹⁶,Saad Ahmed¹⁶,Kaur Mandeep¹⁶,Wilson Michael¹⁶,Bradley Alison¹⁶,Fox Katherine¹⁶,Tomasi Ivan¹⁶,Beasley Daniel¹⁶,Prasanti Alekhya K¹⁶,Kotecha Pinky¹⁶,Ebied Husam¹⁶,Soggiu Fiammetta¹⁶,Paul Michaela¹⁶,Sheth Hemant¹⁶,Gerogiannis Ioannis¹⁶,Gaber Mohannad¹⁶,Sheikh Zara¹⁶,Seth Shatadru¹⁶,Kunitsyna Maria¹⁶,Leo Cosimo A¹⁶,Bellato Vittoria¹⁶,Zafar Noman¹⁶,Elserafy Amr¹⁶,Bond-Smith Giles¹⁶,Tebala Giovanni¹⁶,Mathur Pawan¹⁶,Abid Izza¹⁶,Chidumije Nnaemeka¹⁶,Sandhar Pardip¹⁶,Ullah Syed OZ¹⁶,Lezama Tamara¹⁶,Anwaar Muhammad H¹⁶,Magee Conor¹⁶,Ahmed Salma¹⁶,Davies Brooke¹⁶,Apollos Jeyakumar¹⁶,McCormack Kieran¹⁶,Choudhary Hasham¹⁶,Doulias Triantafyllos¹⁶,Morrison Tamsin¹⁶,Palepa Anna¹⁶,Álvarez Morán Laura¹⁶,Calvo García Haydée¹⁶,Suárez Vega Pilar¹⁶,Estevez Sergio¹⁶,Prieto Calvo Mikel¹⁶,Villalabeitia Ibabe¹⁶,Ausania Fabio¹⁶,Farguell Jordi¹⁶,González-Abós Carolina¹⁶,Sánchez-Cabús Santiago¹⁶,Martín Belén¹⁶,Molina Víctor¹⁶,Oms Luis¹⁶,Ilzarbe Lucas¹⁶,Pont Feijóo Eva¹⁶,Perra Elena S¹⁶,Rojas-Bonet Noel¹⁶,Penalba-Palmí Rafael¹⁶,Pérez-Bru Susana¹⁶,Tur-Martínez Jaume¹⁶,Álvarez-Torrado Andrea¹⁶,Domingo-Gonzalez Marta¹⁶,Tejedor-Tejada Javier¹⁶,García del Alamo Yaiza¹⁶,Mendoza-Moreno Fernando¹⁶,García-Moreno-Nisa Francisca¹⁶,Matías-García Belén¹⁶,Durán Manuel¹⁶,Calleja-Lozano Rafael¹⁶,Perez de Villar José M¹⁶,Sánchez-Guillén Luis¹⁶,Caravaca Iban¹⁶,Triguero-Cánovas Daniel¹⁶,Maya Aparicio Antonio C¹⁶,Durán Meléndez Blas¹⁶,Masiá Palacios Andrea¹⁶,Landaluce-Olavarria Aitor¹⁶,De Francisco Mario¹⁶,Estraviz-Mateos Begoña¹⁶,Alconchel Felipe¹⁶,Nicolás-López Tatiana¹⁶,Ramírez Pablo¹⁶,Muñoz-Cruzado Virginia D¹⁶,Pareja Ciuró Felipe¹⁶,Perea del Pozo Eduardo¹⁶,Olivares Pizarro Sergio¹⁶,Herrera Cabrera Vicente¹⁶,Muros Bayo Jose¹⁶,

Affiliation:

1. Division of Hepatobiliary and Liver Transplantation Surgery, A.O.R.N. Cardarelli, Naples, Italy

2. Hepatobiliary Surgery Unit, Hospital del Mar, Barcelona, Spain

3. Department of Surgery, Nicola Giannettasio Hospital, Corigliano-Rossano, Italy

4. Department of Pharmacy, Health, and Nutritional Sciences, University of Calabria, Rende, Italy

5. Department of Advanced Medical and Surgical Sciences, Università degli Studi della Campania, Luigi Vanvitelli, Naples, Italy

6. Colorectal Surgery Unit, Vall d’Hebron University Hospital, Barcelona, Spain

7. Department of Surgery, Madonna del Soccorso Hospital, San Benedetto del Tronto, Italy

8. Department of Emergency and Trauma Surgery, Bufalini Hospital, Cesena, Italy

9. Department of Emergency and Metabolic Minimally Invasive Surgery, Centre Hospitalier Intercommunal de Poissy/Saint Germain en Laye, Poissy Cedex, France

10. General, Emergency, and Trauma Surgery Unit, Pisa University Hospital, Pisa, Italy

11. Department of Surgery, Macerata Civil Hospital, Macerata, Italy

12. Department of Upper Gastrointestinal Surgery, Royal Infirmary of Edinburgh, Edinburgh, Scotland, UK

13. Centre for Inflammation Research, Clinical Surgery, University of Edinburgh, Edinburgh, Scotland, UK

14. Department of Surgical Science, University of Cagliari, Cagliari, Italy

15. Department of Abdominal Surgery, Abdominal Center, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland

16. for the MANCTRA-1 Collaborative Group

Abstract

ImportanceConsidering the lack of equipoise regarding the timing of cholecystectomy in patients with moderately severe and severe acute biliary pancreatitis (ABP), it is critical to assess this issue.ObjectiveTo assess the outcomes of early cholecystectomy (EC) in patients with moderately severe and severe ABP.Design, Settings, and ParticipantsThis cohort study retrospectively analyzed real-life data from the MANCTRA-1 (Compliance With Evidence-Based Clinical Guidelines in the Management of Acute Biliary Pancreatitis) data set, assessing 5304 consecutive patients hospitalized between January 1, 2019, and December 31, 2020, for ABP from 42 countries. A total of 3696 patients who were hospitalized for ABP and underwent cholecystectomy were included in the analysis; of these, 1202 underwent EC, defined as a cholecystectomy performed within 14 days of admission. Univariable and multivariable logistic regression models were used to identify prognostic factors of mortality and morbidity. Data analysis was performed from January to February 2023.Main OutcomesMortality and morbidity after EC.ResultsOf the 3696 patients (mean [SD] age, 58.5 [17.8] years; 1907 [51.5%] female) included in the analysis, 1202 (32.5%) underwent EC and 2494 (67.5%) underwent delayed cholecystectomy (DC). Overall, EC presented an increased risk of postoperative mortality (1.4% vs 0.1%, P &lt; .001) and morbidity (7.7% vs 3.7%, P &lt; .001) compared with DC. On the multivariable analysis, moderately severe and severe ABP were associated with increased mortality (odds ratio [OR], 361.46; 95% CI, 2.28-57 212.31; P = .02) and morbidity (OR, 2.64; 95% CI, 1.35-5.19; P = .005). In patients with moderately severe and severe ABP (n = 108), EC was associated with an increased risk of mortality (16 [15.5%] vs 0 [0%], P &lt; .001), morbidity (30 [30.3%] vs 57 [5.5%], P &lt; .001), bile leakage (2 [2.4%] vs 4 [0.4%], P = .02), and infections (12 [14.6%] vs 4 [0.4%], P &lt; .001) compared with patients with mild ABP who underwent EC. In patients with moderately severe and severe ABP (n = 108), EC was associated with higher mortality (16 [15.5%] vs 2 [1.2%], P &lt; .001), morbidity (30 [30.3%] vs 17 [10.3%], P &lt; .001), and infections (12 [14.6%] vs 2 [1.3%], P &lt; .001) compared with patients with moderately severe and severe ABP who underwent DC. On the multivariable analysis, the patient’s age (OR, 1.12; 95% CI, 1.02-1.36; P = .03) and American Society of Anesthesiologists score (OR, 5.91; 95% CI, 1.06-32.78; P = .04) were associated with mortality; severe complications of ABP were associated with increased mortality (OR, 50.04; 95% CI, 2.37-1058.01; P = .01) and morbidity (OR, 33.64; 95% CI, 3.19-354.73; P = .003).Conclusions and RelevanceThis cohort study’s findings suggest that EC should be considered carefully in patients with moderately severe and severe ABP, as it was associated with increased postoperative mortality and morbidity. However, older and more fragile patients manifesting severe complications related to ABP should most likely not be considered for EC.

Publisher

American Medical Association (AMA)

Subject

Surgery

Link

https://jamanetwork.com/journals/jamasurgery/articlepdf/2808711/jamasurgery_di_martino_2023_oi_230054_1705503956.70074.pdf

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