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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