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Table 3 Timing of cholecystectomy in people with ACC

From: 2020 World Society of Emergency Surgery updated guidelines for the diagnosis and treatment of acute calculus cholecystitis

Study name

Timing of surgery in early group

Number of participants in early group

Timing of surgery in intermediate or delayed group

Number of participants in intermediate or delayed group

Risk of biasa

Davila 1999 (1)

< 4 days after diagnosis

27

2 months after discharge

36

Unclear

Gul 2013 (2)

< 72 h after hospital admission

30

6 to 12 weeks after initial conservative treatment

30

High

Gutt 2013 (3)

< 24 h after hospital admission

304

7 to 45 days after hospital admission2

314

Low

Johansson 2003 (4)

< 7 days of diagnosis

74

6 to 8 weeks after discharge

71

Low

Kolla 2004 (5)

< 24 h after randomisation

20

6 to 12 weeks after the acute episode subsides

20

Low

Lai 1998 (6)

< 24 h after randomisation

53

6 to 8 weeks after the acute episode subsides

51

Low

Lo 1998 (7)

< 72 h after admission

45

8 to 12 weeks after discharge

41

High

Macafee 2009 (8)

< 72 h after recruitment

Not stated

3 months after discharge

Not stated

High

Mustafa 2016 (9)

< 48 to 72 h of diagnosis

105

6 to 12 weeks after initial attack

105

High

Ozkardes 2014 (10)

< 24 h of admission

30

6 to 8 weeks after initial treatment

30

High

Rajcok 2016 (11)

< 72 h after occurrence of symptoms

32

6 to 8 weeks after acute cholecystitis

32

High

Roulin 2016 (12)

During day as soon as possible

42

6 weeks after initial diagnosis

44

High

Saber 2014 (13)

< 72 h of duration of symptoms

60

6 to 8 weeks from onset of symptoms

60

High

Verma 2013 (14)

< 72 h of admission

30

6 to 8 weeks from onset of symptoms

30

High

Yadav 2009 (15)

As soon as possible

25

6 to 8 weeks after discharge

25

High

Zahur 2014 (16)

< 24 to 48 h after hospital admission

47

6 to 8 weeks after initial conservative treatment

41

High

  1. Main reasons for unclear or high risk of bias
  2. High risk of bias: at least one of random sequence generation, allocation concealment, missing outcome bias or selective outcome reporting bias was classified as high risk of bias
  3. Unclear risk of bias: at least one of random sequence generation, allocation concealment, missing outcome bias or selective outcome reporting bias was classified as unclear risk of bias without any of the domains being classified as high risk of bias
  4. aAll studies were at high risk of bias due to lack of blinding. The risk of bias classification stated here is for the remaining domains
  5. bThis was the only study in which intermediate laparoscopic cholecystectomy was performed; delayed laparoscopic cholecystectomy was performed in the remaining studies