Early versus delayed laparoscopic cholecystectomy for the treatment of acute cholecystitis

ABSTRACT

Patients with a preoperative diagnosis of acute cholecystitis were prospectively allocated to treatment with early laparoscopic cholecystectomy within 24 hs of randomization or initial conservative treatment followed by delayed laparoscopic cholecystectomy 6-8 weeks later. There were 31 patients in the early group and 27 in the delayed group. There were no significant difference in conversion rate[early 19.4 percent versus delayed 22 percent], postoperative analgesic requirement [2 versus 1 dose]. Intra and postoperative complications. However, the early group has significantly longer operating time [112.5 versus 96.4 min, P=0.03] and shorter total hospital stay [3.7 versus 2.2 days, P<0.001]. The incidence of bacterial complications being markedly low, especially in the early group.These results indicate early laparoscopic cholecystectomy is safe and feasible for acute cholecystitis with the additional benefit of shorter total hospital stay and avoid the problems of failed conservative treatment and delayed surgery