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

  • STATUS
    Recruiting
  • days left to enroll
    31
  • participants needed
    200
  • sponsor
    Kuopio University Hospital
Updated on 28 October 2021
conservative management
cholecystectomy
cholelithiasis
Accepts healthy volunteers

Summary

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.

Description

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.

Details
Condition Acute cholecystitis
Treatment Non-operative treatment, laparoscopic cholecystectomy
Clinical Study IdentifierNCT02972944
SponsorKuopio University Hospital
Last Modified on28 October 2021

Eligibility

Yes No Not Sure

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
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