Acute cholecystitis; early versus interval cholecystectomy for a comparative study

ABSTRACT

Gallstones are common biliary pathology. The Vast majority of subjects are asymptomatic. About 0.2% of the population suffering from gallstones develop acute cholecystitis every year. In case of acute calculous cholecystitis, cholecystectomy can be performed early i.e during the same admission or interval i.e after 6 weeks of conservative management. To compare the early and interval cholecystectomy in acute calculous cholecystitis for morbidity, postoperative hospital stay, total hospital stay and complications. Study Design: Quasi-experimental study. Department of Surgery Bahawal Victoria Hospital Bahawalpur. Two year study from December 2007 to December 2009. Sixty patients fulfilling the inclusion criteria were selected for this study. The patients were divided into two groups. Group A patients were managed by early cholecystectomy and group B patients by interval cholecystectomy. Postoperatively patients were evaluated for postoperative hospital stay, total hospital stay and postoperative complications. The mean age of the patients in group A was 42.2 + 1 0.7 years and in group B was 42.2+ 1 0.7 years. The Male to female ratio was 14 in both groups. The mean postoperative hospital stay in group A was 4.0+ 1 .Sdays and in group B was 3.8+ 1 .4 days. The mean total hospital stay in group A was 6.5 + 1 .7 days and in group B was 10.2 + 1 .3 days. The P value was less than 0.001, which was significant. In distribution of postoperative complications, in group A there were 1[3.3%] injury to biliary tree, 4[13.3%] wound infection, 1[3.3%] wound haematoma, 3 [10%] seroma and 1[3.3%] wound dehiscence. While in group B there were 1 [3.3%] injury to biliary tree, 3[10%] wound infection,2 [6.7%] wound haematoma, 2[6.7%] and no patient of wound dehiscence. Our study suggests that early cholecystectomy is a better treatment option than interval cholecystectomy because it has less total hospital stay, needs single hospital visit and has no risk of developing complications during wait for surgery