What is the Optimal Timing for Laparoscopic Cholecystectomy in Acute Cholecystitis

Shin, Jun Ho

Abstract

PURPOSE: As surgical treatment for acute cholecystitis, laparoscopic cholecystectomy is not con traindication, but optimal time to carry out laparoscopic cholecystectomy for acute cholecystitis remains controversial. We compared the results between early and delayed laparoscopic cholecystectomy and established the optimal time to perform laparoscopic cholecystectomy for patient with acute cholecystitis.
METHODS
Retrospective study has been conducted on a total of 94 cases of patients hospitalized in the department of surgery from November, 1995 to June, 1998. We defined the operations performed within 48 hours as early cholecystectomy and the other ones performed after 48 hours as delayed cho lecystectomy. RESULTS: The two groups (early one 46 cases, late one 48 cases) did not show significant differences in sex and age. The duration of anesthesia and operation was 142 minutes and 118 minutes respectively in early group, 120 minutes and 95 minutes respectively in delayed group with no significant difference. Conversion rate to open surgery was 8.7% (4/46) in the early group and 8.3% (4/48) in the late group with no significant difference. Complication rate came up to 17.4% (8 cases) in early group, a total of 8 cases (16.7%) in delayed group with no significant difference. Postoperative hospital stay did not show significant difference with 8.0 days in early group and 9.2 days in delayed group. CONCLUSION: This study showed that laparoscopic cholecystectomy for acute cholecystitis can be performed safely at any time of onset of symptoms but should be reassessed hereafter by going through more cases.