Acute cholecystitis in high risk surgical patients: percutaneous cholecystostomy versus laparoscopic cholecystectomy (CHOCOLATE trial): study protocol for a randomized controlled trial

• Published in: Current controlled trials in cardiovascular medicine Vol. 13; no. 1; p. 7
• Main Authors: Kortram, Kirsten, van Ramshorst, Bert, Bollen, Thomas L, Besselink, Marc G H, Gouma, Dirk J, Karsten, Tom, Kruyt, Philip M, Nieuwenhuijzen, Grard A P, Kelder, Johannes C, Tromp, Ellen, Boerma, Djamila
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 12.01.2012; BioMed Central; BMC
• Subjects: Abdomen; Acute cholecystitis; Antibiotics; Care and treatment; Cholecystectomy; Cholecystectomy, Laparoscopic - adverse effects; Cholecystectomy, Laparoscopic - economics; Cholecystectomy, Laparoscopic - mortality; Cholecystitis; Cholecystitis, Acute - diagnosis; Cholecystitis, Acute - economics; Cholecystitis, Acute - mortality; Cholecystitis, Acute - surgery; Cholecystostomy - adverse effects; Cholecystostomy - economics; Cholecystostomy - methods; Cholecystostomy - mortality; Comorbidity; Diagnosis; Emergency medical care; Gallbladder diseases; Gallstones; Hospital Costs; Hospitals; Hospitals, Teaching; Humans; Infections; Informed consent; Intensive care; laparoscopic cholecystectomy; Laparoscopic surgery; Laparoscopy; Length of Stay; Morbidity; Mortality; Netherlands; Patients; percutaneous cholecystostomy; percutaneous drainage; Research Design; Risk Assessment; Risk Factors; Study Protocol; Success; Surgical anastomosis; Time Factors; Treatment Outcome; Ultrasonic imaging; United States; Netherlands; United States
• ISSN: 1745-6215; 1745-6215
• DOI: 10.1186/1745-6215-13-7

Laparoscopic cholecystectomy in acute calculous cholecystitis in high risk patients can lead to significant morbidity and mortality. Percutaneous cholecystostomy may be an alternative treatment option but the current literature does not provide the surgical community with evidence based advice. The CHOCOLATE trial is a randomised controlled, parallel-group, superiority multicenter trial. High risk patients, defined as APACHE-II score 7-14, with acute calculous cholecystitis will be randomised to laparoscopic cholecystectomy or percutaneous cholecystostomy. During a two year period 284 patients will be enrolled from 30 high volume teaching hospitals. The primary endpoint is a composite endpoint of major complications within three months following randomization and need for re-intervention and mortality during the follow-up period of one year. Secondary endpoints include all other complications, duration of hospital admission, difficulty of procedures and total costs. The CHOCOLATE trial is designed to provide the surgical community with an evidence based guideline in the treatment of acute calculous cholecystitis in high risk patients. Netherlands Trial Register (NTR): NTR2666.