Early cholecystectomy for acute cholecystitis

To compare early cholecystectomy at the same admission and delayed elective cholecystectomy for acute cholecystitis. We studied 171 patients retrospectively admitted to the Surgical Department with provisional diagnosis of acute cholecystitis. Comparative study of the clinical picture investigation, operative finding, hospital stay and complication in early same admission cholecystectomy and delayed elective cholecystectomy. To highlight the advantages and safety of early cholecystectomy compared with a delayed operation. Out of 171 patients, 96 patients were operated at the same admission compared with 75 who were treated conservatively, discharged and re-admitted after at least 6 weeks for elective operation. Male and females were equally affected. A high percentage had empyema of gallbladder: 45% in the early group. In the early cholecystectomy group, 70% had less than 2 weeks' hospital stay compared with 88% who had over a week's hospitalization. In the early cholecystectomy group there was only 1% mortality. Early cholecystectomy is preferred rather than delayed elective cholecystectomy because there are fewer patient relapses and it is considered a safe procedure provided it is performed by an experienced surgeon; it also means less cost to the hospital as the stay is shorter

Laparoscopic cholecystectomy in a safe and effective method in treating acute cholecystitis

In a series of 230 cases, laparoscopic cholecystectomy was attempted in 18 patients having the clinical picture of acute cholecystitis, 4 cases were non-calcular by preoperative sonar which revealed thick edematous wall of the gallbladder in 13 patients. All patients were scheduled for operation 72 hours or less from the attack. There was a significant discrepancy between the clinical picture and the laparoscopic finding of the gallbladder. The average operative time was 105 minutes. Dissection of the gallbladder was done by "fundus first" method in 3 cases. The hospital stay ranged from 18 to 48 hours. Two cases were converted to open surgery because of severe inflammation obscuring the anatomy. No mortality or significant morbidity were reported. It was concluded that laparoscopic cholecystectomy is safe and effective method in treating patients with acute cholecystitis and these patients should not be denied the benefits of laparoscopic cholecystectomy in centers with appropriate experience