Publication:

Early versus delayed laparoscopic cholecystectomy for acute cholecystitis: a comparative study

Background Laparoscopic cholecystectomy is now the procedure of choice for patient presenting with acute cholecystitis unless it is contraindicated for technical reason or safety. An attempt was made to compare the outcome and postoperative complications of early vs delayed laparoscopic cholecystectomy in acute cholecystitis.

Methods Fifty patients aged 18 to 64 years having acute cholecystitis admitted for laparoscopic cholecystectomy were included. They were divided into two groups, early (less than 72 hours) and delayed (more than 72 hours up to 6 weeks) laparoscopic cholecystectomy. The patients were followed for three months after the surgery. The primary outcome measures were conversion to open surgery and postoperative complications whereas secondary outcome measures were hospital stay and return to full activity. Comparison of quantitative variables and qualitative variables was done using unpaired student’s “t” test and chi-square test/ Fisher’s exact test respectively.

Results Conversion to open cholecystectomy (p = 0.007) and post-operative complications (p = 0.032) were significantly less in early laparoscopic cholecystectomy group compared to delayed laparoscopic cholecystectomy group. Mean days of hospital stay (4.9 versus 7.4 with p = 0.001) and mean days of return to full activities (12.6 vs 16.3 days with p = 0.001) was significantly less in early laparoscopic surgery group compared to delayed laparoscopic cholecystectomy group. Mean duration of surgery was significantly less in early laparoscopic surgery group as compared to delayed laparoscopic surgery group (69.3 versus 108.5 minutes, with p = 0.001).

Conclusions Early laparoscopic cholecystectomy is better choice than delayed laparoscopic cholecystectomy in acute cholecystitis.