Early laparoscopic cholecystectomy in acute cholecystitis: safety and advantages

Abstract

Background: Cholecystectomy is a widely performed procedure all over world though popularized late in India. Today, Laparoscopic cholecystectomy is the method of choice to remove gall bladder. A concern exists in the minds of surgeons when it comes to immediate removal of an acutely inflammed gall bladder, laparoscopically. To analyze this hesitation, statistically, this study has been carried out.Methods: A prospective and randomized study was conducted among 66 patients from March 2013 to February 2016. Thirty three patients presenting with acute calculous cholecystitis were subjected to delayed laparoscopic cholecystectomy (Group A) after an initial conservative treatment and gap of 6-8 weeks. Another group of 33 patients presenting with acute calculous cholecystitis were taken up for laparoscopic cholecystectomy within 72 hours of onset of symptoms (Group B). Results obtained, in both the groups, under different headings were compared and analyzed.Results: Time taken for early laparoscopic cholecystectomy was significantly higher than that for delayed laparoscopic cholecystectomy. Cost of treatment and total hospital stay in delayed group was significantly high as compared to early group. No significant difference was found in incidence of conversion rate, common bile duct (CBD) and gastrointestinal tract (GIT) injury, requirement of drain, postoperative pain and analgesia requirement and port related complications.Conclusions: Early cholecystectomy in acute cholecystitis is feasible, safe, cheaper and requires shorter hospital stay, if, performed within 72 hours of onset of symptoms.