این مقاله انگلیسی ISI در نشریه الزویر در 7 صفحه در سال 2018 منتشر شده و ترجمه آن 17 صفحه میباشد. کیفیت ترجمه این مقاله رایگان – برنزی ⭐️ بوده و به صورت کامل ترجمه شده است.
| دانلود رایگان مقاله انگلیسی + خرید ترجمه فارسی | |
| عنوان فارسی مقاله: |
پیامدهای کولسیستکتومی زودهنگام در برابر کولسیستکتومی تاخیری در بیماران با پانکراتیت صفراوی حاد: یک مطالعه آینده نگرانه تصادفی |
| عنوان انگلیسی مقاله: |
Outcomes of early versus delayed cholecystectomy in patients with mild to moderate acute biliary pancreatitis: A randomized prospective study |
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| مشخصات مقاله انگلیسی (PDF) | |
| سال انتشار | 2018 |
| تعداد صفحات مقاله انگلیسی | 7 صفحه با فرمت pdf |
| رشته های مرتبط با این مقاله | پزشکی |
| گرایش های مرتبط با این مقاله | گوارش و کبد، پزشکی داخلی |
| چاپ شده در مجله (ژورنال) | مجله آسیایی جراحی – Asian Journal of Surgery |
| کلمات کلیدی | پانکراتیت صفراوی، کولسیستکتومی، رویداد های صفراوی مکرر، ERCP |
| رفرنس | دارد ✓ |
| کد محصول | F1421 |
| نشریه | الزویر – Elsevier |
| مشخصات و وضعیت ترجمه فارسی این مقاله | |
| وضعیت ترجمه | انجام شده و آماده دانلود |
| تعداد صفحات ترجمه تایپ شده با فرمت ورد با قابلیت ویرایش | 17 صفحه (1 صفحه رفرنس انگلیسی) با فونت 14 B Nazanin |
| ترجمه عناوین جداول | ترجمه شده است ✓ |
| ترجمه متون داخل جداول | ترجمه شده است ✓ |
| درج جداول در فایل ترجمه | درج شده است ✓ |
| کیفیت ترجمه | کیفیت ترجمه این مقاله پایین میباشد |
| فهرست مطالب |
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چکیده |
| بخشی از ترجمه |
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چکیده نتیجه در ABP خفیف تا متوسط ، کوله سیستکتومی زودرس لاپاروسکوپی خطر بروز حوادث مجدد صفراوی را بدون افزایش مشکل در عمل یا عوارض جانبی بعد از عمل کاهش می دهد. |
| بخشی از مقاله انگلیسی |
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Abstract Background In patients with acute biliary pancreatitis (ABP), cholecystectomy is mandatory to prevent further biliary events, but the precise timing of cholecystectomy for mild to moderate disease remain a subject of ongoing debate. The aim of this study is to assess the outcomes of early versus delayed cholecystectomy. We hypothesize that early cholecystectomy as compared to delayed cholecystectomy reduces recurrent biliary events without a higher peri-operative complication rate. Methods Patients with mild to moderate ABP were prospectively randomized to either an early cholecystectomy versus a delayed cholecystectomy group. Recurrent biliary events, peri-operative complications, conversion rate, length of surgery and total hospital length of stay between the two groups were evaluated. Results A total of 72 patients were enrolled at a single public hospital. Of them, 38 were randomized to the early group and 34 patients to the delayed group. There were no differences regarding peri-operative complications (7.78% vs 11.76%; p = 0.700), conversion rate to open surgery (10.53% vs 11.76%; p = 1.000) and duration of surgery performed (80 vs 85 minutes, p = 0.752). Nevertheless, a greater rate of recurrent biliary events was found in the delayed group (44.12% vs 0%; p ≤ 0.0001) and the hospital length of stay was longer in the delayed group (9 vs 8 days, p = 0.002). Conclusion In mild to moderate ABP, early laparoscopic cholecystectomy reduces the risk of recurrent biliary events without an increase in operative difficulty or perioperative morbidity.. 1- Introduction Gallstone disease is the leading cause of acute pancreatitis in developed nations, accounting for up to 75% of cases.1 In Malaysia, a retrospective study done over a period of 7 years showed that in nearly one-half of the patients (45.1%) admitted for acute pancreatitis, the etiology was biliary calculi, followed by alcohol intake (19.7%).2 After biliary pancreatitis, patients may experience a recurrent episode of biliary pancreatitis, common bile duct (CBD) obstruction, cholangitis, or biliary colics.3,4 Cholecystectomy and clearance of stones from the biliary tree remain the mainstay of treatment to prevent recurrent biliary events.1,5 Most cases of acute biliary pancreatitis (ABP) are mild and self limiting; however, 10e20% of patients develop severe pancreatitis, which is associated with high morbidity and mortality.5 The timing of cholecystectomy in patients with clinically severe pancreatitis, with local complications such as pancreatic necrosis and organ failure, is deliberately delayed until local complications have resolved, typically after approximately 6 weeks.6 For mild to moderate ABP, international guidelines recommend early cholecystectomy.1,3e5,7,8 However, the definition of “early” varies amongst the guidelines. The International Association of Pancreatology (IAP) recommends that all patients with gallstone pancreatitis should undergo cholecystectomy as soon as the patient has recovered from the attacks,1 whereas the British Society of Gastroenterology recommend cholecystectomy within the same hospital admission or up to 2 weeks after discharge.4 The American Gastroenterological Association guidelines suggest that cholecystectomy should be performed as soon as possible and in no case beyond 2e4 weeks after discharge,3 whereas the American College of Gastroenterology recommend cholecystectomy within index admission.8 The variation in the recommended timing of cholecystectomy between these guidelines arose from differing views and adopted practices, and more importantly, is due to the lack of evidence from prospective randomized controlled trials addressing the timing and safety of early operative intervention. Several nonrandomized studies published recently favor cholecystectomy during the same index admission for ABP.9e13 The rationale for cholecystectomy during the same hospitalization, compared with interval cholecystectomy, is that it leads to a reduction in the frequency of recurrent biliary events (e.g., recurrent biliary pancreatitis, acute cholecystitis, symptomatic choledocholithiasis, and biliary colic) in these patients. Ito et al14 noted that there is an increased risk of recurrence within 2e4 weeks after discharge. In the group of patients who did not have cholecystectomy performed during the index admission, 13.4% developed recurrent ABP while awaiting cholecystectomy. A total of 12.5% of recurrences occurred within 1 week, 31.3% occurred within 2 weeks, and one-half of them within 4 weeks after discharge.14 This finding is crucial as recurrent attacks of biliary pancreatitis can be severe and life threatening. Despite these guidelines and literatures, cholecystectomy during the same admission is not commonly practiced. A recent study of over 25,000 patients acutely admitted to hospitals in England with gallstone-related disease showed that only 14.7% underwent cholecystectomy during the same admission.15 Another study in the US showed that only half of the patients admitted for ABP had cholecystectomy done during the same admission. Patients admitted to hospitals with smaller annual volumes of cholecystectomy or higher annual volumes of acute pancreatitis admissions were less likely to undergo cholecystectomy during the initial hospitalization for ABP.16 A nationwide study in the Netherlands demonstrated that three-quarters of the patients admitted with mild biliary pancreatitis underwent cholecystectomy a median of 6 weeks after discharge.13 The majority of specialists perform an interval cholecystectomy due to uncertainty regarding the efficacy and safety of an early cholecystectomy. The lack of evidence from prospective randomized controlled trials may contribute to that. Limitations to hospital resources, such as access to surgeons, operating room time, and postoperative intensive unit beds, may also contribute to noncompliance to recommendations for early cholecystectomy. Other definitive biliary interventions such as endoscopic retrograde cholangiopancreatography (ERCP) with endoscopic sphincterotomy (ES) can also independently reduce rates of recurrence of ABP but may result in higher rates of biliary complications when compared with cholecystectomy.17 ERCP and ES alone without cholecystectomy as definitive therapy for ABP still remain controversial. ERCP with its higher incidence of postprocedure pancreatitis resulted in longer hospital length of stay when compared with laparoscopic cholecystectomy and intraoperative cholangiogram (IOC) even when common bile duct exploration was performed.18 Nevertheless, ES can be used as an accepted definitive treatment in elderly patients who have multiple comorbid conditions and are not fit for surgery to prevent recurrence of pancreatitis. To date, there is only one published prospective randomized controlled trial in the US looking into the timing of cholecystectomy after ABP in 50 patients.19 In this study, there was no comparison group randomized to undergo cholecystectomy electively after discharge. Moreover, this trial did not assess the efficacy of early cholecystectomy on long term outcomes such as recurrent biliary events. In this study, we performed a comparative study of the outcomes of patients with early (cholecystectomy done within index admission) versus delayed cholecystectomy (cholecystectomy done on an elective basis after discharge, at w 6 weeks), concentrating only on patients with mild to moderate acute biliary pancreatitis. We hypothesize that early cholecystectomy compared with delayed cholecystectomy in patients with mild to moderate ABP reduces recurrent biliary events without a higher perioperative complication rate.. |
| دانلود رایگان مقاله انگلیسی + خرید ترجمه فارسی | |
| عنوان فارسی مقاله: |
پیامدهای کولسیستکتومی زودهنگام در برابر کولسیستکتومی تاخیری در بیماران با پانکراتیت صفراوی حاد: یک مطالعه آینده نگرانه تصادفی |
| عنوان انگلیسی مقاله: |
Outcomes of early versus delayed cholecystectomy in patients with mild to moderate acute biliary pancreatitis: A randomized prospective study |
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