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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
6 Wikipedia pages

Citations

dimensions_citation
115 Dimensions

Readers on

mendeley
121 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 121 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 118 98%

Demographic breakdown

Readers by professional status Count As %
Researcher 16 13%
Other 14 12%
Student > Ph. D. Student 14 12%
Student > Master 11 9%
Student > Postgraduate 10 8%
Other 33 27%
Unknown 23 19%
Readers by discipline Count As %
Medicine and Dentistry 68 56%
Nursing and Health Professions 7 6%
Social Sciences 4 3%
Pharmacology, Toxicology and Pharmaceutical Science 3 2%
Agricultural and Biological Sciences 2 2%
Other 6 5%
Unknown 31 26%

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 01 July 2022.
All research outputs
#6,410,071
of 22,774,233 outputs
Outputs from Cochrane database of systematic reviews
#8,218
of 12,314 outputs
Outputs of similar age
#22,509
of 75,561 outputs
Outputs of similar age from Cochrane database of systematic reviews
#40
of 67 outputs
Altmetric has tracked 22,774,233 research outputs across all sources so far. This one has received more attention than most of these and is in the 70th percentile.
So far Altmetric has tracked 12,314 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 30.4. This one is in the 31st percentile – i.e., 31% 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 75,561 tracked outputs that were published within six weeks on either side of this one in any source. This one has gotten more attention than average, scoring higher than 68% of its contemporaries.
We're also able to compare this research output to 67 others from the same source and published within six weeks on either side of this one. This one is in the 37th percentile – i.e., 37% of its contemporaries scored the same or lower than it.