Outcomes and complications after appendectomy and cholecystectomy in emergency surgical practice: a systematic review and meta-analysis

Osman Suliman; Ali Fadhel; Khalid AboZena; Ibrahim Aljohani; Mohammed Albensari; Khalid Almutair; Sara Altom; Omer Abdelbagi; Riham Abdelmagid; Ahmed Abdelmagid

doi:10.18203/2394-6040.ijcmph20260745

Authors

Osman Suliman Department of Surgery, Faculty of Medicine, University of Medical Sciences and Technology, Khartoum, Sudan
Ali Fadhel Al-Rayan National College of Medicine, Al-Rayan National Colleges, Al-Madinah, Saudi Arabia
Khalid AboZena Al-Rayan National College of Medicine, Al-Rayan National Colleges, Al-Madinah, Saudi Arabia
Ibrahim Aljohani Al-Rayan National College of Medicine, Al-Rayan National Colleges, Al-Madinah, Saudi Arabia
Mohammed Albensari Al-Rayan National College of Medicine, Al-Rayan National Colleges, Al-Madinah, Saudi Arabia
Khalid Almutair Al-Rayan National College of Medicine, Al-Rayan National Colleges, Al-Madinah, Saudi Arabia
Sara Altom Department of Basic Sciences, Al-Rayan National College of Medicine, Al-Rayan National Colleges, Al-Madinah, Saudi Arabia
Omer Abdelbagi Department of Surgery, Main Hospital, King Salman bin Abdulaziz Medical City Al-Madinah, Saudi Arabia
Riham Abdelmagid Faculty of Medicine, Capital University, Cairo, Egypt
Ahmed Abdelmagid Emergency Department, St. George’s Hospital Foundation Trust. London, United Kingdom

DOI:

https://doi.org/10.18203/2394-6040.ijcmph20260745

Keywords:

Acute care surgery, Appendectomy, Cholecystectomy, Postoperative complications, Emergency General surgery

Abstract

Acute care surgery (ACS) was developed as a consultant led organizational framework designed to enhance the promptness and quality of emergency general surgical care. Appendectomy and cholecystectomy are considered standard ACS procedures; nevertheless, the reported rates of postoperative complications are varied, attributed to differences in patient demographics, illness severity, surgical care, and institutional policies. This meta-analysis, executed in alignment with PRISMA 2020 recommendations, assessed publications published from January 2010 to December 2025 that investigated postoperative outcomes following emergency appendectomy and cholecystectomy within the contexts of ACS or emergency general surgery. Eligible trials comprised adult or mixed-age groups with recorded perioperative outcomes. Independent reviewers did the data extraction and quality check. When it made sense, random-effects meta-analyses were done, and the I² statistic was used to measure heterogeneity. Evidence synthesis demonstrated that the application of ACS typically improves surgical speed, reduces hospital length of stay, and yields comparable or diminished postoperative complication rates in contrast to conventional on call systems. Infections at the surgical site, damage to the bile duct, bile leaks, and abscesses in the abdomen were all common problems. Comorbidity, illness severity, operating delay, and open surgical conversion were all factors that led to bad outcomes. On the other hand, early intervention and minimally intrusive methods were always linked to better results. In general, ACS-based care is a good and flexible way to handle emergency appendectomy and cholecystectomy. It follows the rules of quality, safety, and efficient use of resources. The ongoing diversity among studies highlights the necessity for defined care pathways and sustained high-quality research focused on ACS.

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