J Minim Invasive Surg.  2022 Dec;25(4):139-144. 10.7602/jmis.2022.25.4.139.

Evaluation of early versus delayed laparoscopic cholecystectomy in acute calculous cholecystitis: a prospective, randomized study

• Gupta G
• Shahbaj A
• Pipal DK
• Saini P
• Verma V
• Gupta S
• Rani V
• Yadav S

• KMID: 2538951
• DOI: http://doi.org/10.7602/jmis.2022.25.4.139

Abstract

Purpose
Uncertainty exists about whether early laparoscopic cholecystectomy (LC) is an appropriate surgical treatment for acute calculous cholecystitis. This study aimed to compare early vs. late LC for acute calculous cholecystitis regarding intraoperative difficulty and postoperative outcomes.
Methods
This was a prospective randomized study carried out between December 2015 and June 2017; 60 patients with acute calculous cholecystitis were divided into two groups (early and delayed groups), each comprising 30 patients. Thirty patients treated with LC within 3 to 5 days of arrival at the hospital were assigned to the early group. The other 30 patients were placed in the delayed group, first treated conservatively, and followed by LC 3 to 6 weeks later.
Results
The conversion rates in both groups were 6.7% and 0%, respectively (p = 0.143). The operating time was 56.67 ± 11.70 minutes in the early group and 75.67 ± 20.52 minutes in the delayed group (p = 0.001), and both groups observed equal levels of postoperative complications. Early LC patients, on the other hand, required much fewer postoperative hospital stay (3.40 ± 1.99 vs. 6.27 ± 2.90 days, p = 0.006).
Conclusion
Considering shorter operative time and hospital stay without significant increase of open conversion rates, early LC might have benefits over late LC.

Keyword

Acute cholecystitis; Gallstones; Laparoscopic cholecystectomy; Treatment outcome