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Cochrane Database of Systematic Reviews

Cholecystectomy deferral in patients with endoscopic sphincterotomy

Overview of attention for article published in Cochrane database of systematic reviews, October 2007
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Mentioned by

twitter
1 tweeter
wikipedia
2 Wikipedia pages

Citations

dimensions_citation
105 Dimensions

Readers on

mendeley
110 Mendeley
Title
Cholecystectomy deferral in patients with endoscopic sphincterotomy
Published in
Cochrane database of systematic reviews, October 2007
DOI 10.1002/14651858.cd006233.pub2
Pubmed ID
Authors

Vivian McAlister, Eric Davenport, Elizabeth Renouf

Abstract

Cholecystectomy is not required in up to 64% of patients who adopt a wait-and-see policy after endoscopic clearance of common bile duct stones. Although reports of retrospective cohort series have shown a higher mortality among patients who defer cholecystectomy, it is not known if this is due to the patients' premorbid health status or due to the deferral of cholecystectomy. Randomised clinical trials of prophylactic cholecystectomy versus wait-and-see have not had sufficient power to demonstrate differences in survival. To evaluate the beneficial and harmful effects of cholecystectomy deferral (wait-and-see) versus elective (prophylactic) cholecystectomy in patients who have had an endoscopic biliary sphincterotomy. We searched The Cochrane Hepato-Biliary Group Controlled Trials Register, the Cochrane Controlled Trials Register (CENTRAL) in The Cochrane Library, MEDLINE (1966 to 2007), EMBASE (1980 to 2007), and Science Citation Index Expanded without language restrictions until April 2007. Randomised clinical trials comparing patients whose gallbladder was left in-situ after endoscopic sphincterotomy (wait-and-see group) versus patients who had cholecystectomy with either endoscopic sphincterotomy or common bile duct exploration (prophylactic cholecystectomy group), irrespective of blinding, language, or publication status. We assessed the impact of a wait-and-see policy on mortality. Secondary outcomes assessed were the incidence of biliary pain, cholangitis, pancreatitis, need for cholangiography, need for cholecystectomy, and the rate of difficult cholecystectomy. We pooled data using relative risk with fixed-effect and random-effects models. We included 5 randomised trials with 662 participants out of 93 publications identified through the literature searches. The number of deaths was 47 in the wait-and-see group (334 patients) compared to 26 in the prophylactic cholecystectomy group (328 patients) for a 78% increased risk of mortality (RR 1.78, 95% CI 1.15 to 2.75, P = 0.010). The survival benefit of prophylactic cholecystectomy was independent of trial design, inclusion of high risk patients or inclusion of any one of the five trials. Patients in the wait-and-see group had higher rates of recurrent biliary pain (RR 14.56, 95% CI 4.95 to 42.78, P < 00001), jaundice or cholangitis (RR 2.53, 95% CI 1.09 to 5.87, P = 0.03), and of repeat ERCP or other forms of cholangiography (RR 2.36, 95% CI 1.29 to 4.32, P = 0.005). Cholecystectomy was eventually performed in 35% (115 patients) of the wait-and-see group. Prophylactic cholecystectomy should be offered to patients whose gallbladders remain in-situ after endoscopic sphincterotomy and common bile duct clearance.

Twitter Demographics

The data shown below were collected from the profile of 1 tweeter who shared this research output. Click here to find out more about how the information was compiled.

Mendeley readers

The data shown below were compiled from readership statistics for 110 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Spain 1 <1%
United States 1 <1%
France 1 <1%
Unknown 107 97%

Demographic breakdown

Readers by professional status Count As %
Other 14 13%
Researcher 14 13%
Student > Ph. D. Student 13 12%
Student > Master 11 10%
Student > Postgraduate 10 9%
Other 32 29%
Unknown 16 15%
Readers by discipline Count As %
Medicine and Dentistry 66 60%
Nursing and Health Professions 7 6%
Pharmacology, Toxicology and Pharmaceutical Science 3 3%
Social Sciences 3 3%
Agricultural and Biological Sciences 2 2%
Other 6 5%
Unknown 23 21%

Attention Score in Context

This research output has an Altmetric Attention Score of 4. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 17 March 2018.
All research outputs
#3,222,073
of 12,662,942 outputs
Outputs from Cochrane database of systematic reviews
#6,171
of 10,397 outputs
Outputs of similar age
#66,305
of 275,227 outputs
Outputs of similar age from Cochrane database of systematic reviews
#164
of 246 outputs
Altmetric has tracked 12,662,942 research outputs across all sources so far. This one has received more attention than most of these and is in the 73rd percentile.
So far Altmetric has tracked 10,397 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 20.2. This one is in the 39th percentile – i.e., 39% of its peers scored the same or lower than it.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 275,227 tracked outputs that were published within six weeks on either side of this one in any source. This one has done well, scoring higher than 75% of its contemporaries.
We're also able to compare this research output to 246 others from the same source and published within six weeks on either side of this one. This one is in the 32nd percentile – i.e., 32% of its contemporaries scored the same or lower than it.