Publication:

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

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.