Abstract
Laparoscopic cholecystectomy is performed rather commonly by general surgeons for symptomatic gall stones. This study is an analysis of experience for the timing of laparoscopic cholecystectomy for acute cholecystitis performed in Basrah, Iraq, by one surgeon. This study aimed to know the difference between early and delayed laparoscopic cholecystectomy in acute cholecystitis with respect to the hospital stay, conversion rate, and major complications rate. Data were collected from the medical records of patients with acute cholecystitis admitted to the surgical wards during (June 2009 to September 2011). Patients were divided into 2 groups on the basis of treatment received. Length of hospital stay, major complications, and conversion rates were analyzed. Ninety seven patients with acute cholecystitis underwent laparoscopic cholecystectomy. Thirty nine patients (40.2%) treated with early laparoscopic cholecystectomy, fifty eight patients (59.8%) treated with delayed laparoscopic cholecystectomy. Length of stay was significantly shorter in the early laparoscopic cholecystectomy group compared with the delayed laparoscopic cholecystectomy group (P<.001). Conversion rate and major complication rates were not statistically different. In conclusion, early laparoscopic cholecystectomy resulted in a statistically significant reduction of hospital stay, low major complications, and no significant difference in conversion rates when compared with initial antibiotic treatment and delayed laparoscopic cholecystectomy. Despite these advantages, early laparoscopic cholecystectomy is not the most common treatment for acute cholecystitis in practice.
Highlights
Symptomatic gall stones & acute cholecystitis are commonly facing general surgeons[1]
The length of hospital stay was shorter for early laparoscopic cholecystectomy, range (3-8) days; mean (3.53), than delayed group, rang (4-10) days; mean (5.93), with p value less than 0.001, as illustrated in table I
As laparoscopic cholecystectomy became dominant in the early 1990s, some early adopters began to accept the challenge of a laparoscopic approach to acute cholecystitis
Summary
Symptomatic gall stones & acute cholecystitis are commonly facing general surgeons[1]. Cholecystectomy is indicated as recurrent attacks are likely, but recommendation regarding the timing of the surgery has undergone change in recent years[2]. As long as 4 decades ago, surgeons began to recognize that early cholecystectomy is the preferred strategy for managing the acutely inflamed gallbladder because the edematous plane facilitates dissection and single-stage definitive treatment lessens both the total duration of morbidity and the potential for late complications such as gangrenous or emphysematous cholecystitis[3]. Conference stated that laparoscopic cholecystectomy “provides a safe and effective treatment for most patients with symptomatic gallstones6". As laparoscopic cholecystectomy became dominant in the early 1990s, some early adopters began to accept the challenge of a laparoscopic approach to acute
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