Early versus Delayed Laparoscopic Cholecystectomy for Treatment of Acute Calcular Cholecystitis

Abstract

Background: Acute calcular cholecystitis is a common disease. Conservative treatment was the standard treatment option till the advancement of laparoscopic surgery (LC). The surgery becomes the gold standard. However, the timing of surgery is still debatable. The current work aimed to compare between early and delayed LC regarding safety and efficacy profile.

Methodology: We retrospectively evaluated the data of 120 patients (60 in each group), who were presented with acute calcular cholecystitis. Their demographic characteristics, clinical manifestations, results of ultrasound and laboratory investigations were documented. In addition, operative data and postoperative complications were compared between groups.

Results:  Both early and delayed LC groups were comparable regarding patient demographics, preoperative associated medical diseases, and postoperative complications. On the other side, the conversion rate to open surgery was significantly higher in the early than the delayed groups (21.7% vs 8.3%), and operative time was significantly longer in early than delayed groups. The difficulty in gall bladder handling was significantly higher in the early than the delayed group (21% vs 15.0%). However, the duration of hospital stay was significantly shorter in the early than the delayed group (4.12±1.04 vs 9.81±1.68 days, respectively).

Conclusion: Early laparoscopic cholecystectomy is advocated over the delayed approach, as it is associated with shorter hospital stay, with comparable safety and efficacy profile to the delayed laparoscopic cholecystectomy.