Early versus Interval Laparoscopic Cholecystectomy in Acute Calcular Cholecystitis in Grade I and Grade II According to Tokyo Guidelines

Abstract

Abstract Background: Gall stone-related disease is one of the most common ailments that general surgeons treat. Between 10% and 15% of the population have gallstones, and of these, between 1% and 4% will be become symptomatic each year. Aim of Study: The aim of this prospective study is to compare between early and interval laparoscopic cholecystec-tomy for treatment of acute cholecystitis in grade I and grade II according to Tokyo guide lines in post-operative complica-tions hospital stay quality of life and cost. Patients and Methods: This study was analytical prospec-tive study; it was carried out on 20 patients presented with acute calcular cholecystitis admitted in the General Surgery Department at Al-Zahraa University Hospital in the period from April 2018 to November 2019. Results: According to Tokyo guidelines 2013, 12 patients undergone and completed early laparoscopic cholecystectomy (6 patients from mild group and 6 patient from moderate group) while 4 patients treated by delayed laparoscopic cholecystectomy. Only 3 patients (2 in mild group and 2 in moderate group) needed intraoperative conversion. Operative time was longer in open surgery and statistically significant in early lap and conversed cases. Post-operative pain was severe in majorty of patients with open surgery and mild in laparoscopic group. The mean time of starting oral feeding and hospital stay was longer in open surgery than lap chole-cystectomy. Conclusion: These results clarify that application of Tokyo guidelines 2013 was successful in guiding us in determining the proper time of laparoscopic cholecystectomy according to severity.