Is early laparoscopic cholecystectomy a safe procedure in patients when the duration of acute cholecystitis is more than three days?

Abstract

The role of laparoscopic cholecystectomy for patients with acute cholecystitis and symptoms for >3 days is debated. Our purpose was to compare the results of laparoscopic cholecystectomy in patients with acute cholecystitis and symptoms for ≤ 3 days and >3 days. Sixty patients with acute cholecystitis had a laparoscopic cholecystectomy performed by the same surgeon. There were 39 patients in the short group (symptoms ≤ 3 days) and 21 patients in the long group (symptoms >3 days). Demographic data, surgical findings and clinical results were analyzed. There were no significant differences in age, gender, comorbidities, abnormal liver function tests, white bile, gallbladder empyema, blood loss, conversion rate, postoperative hospital stay or complication rates between the groups. The mean duration of acute cholecystitis was 1.9 days in the short group and 5.3 days in the long group (p<0.0001). The long group had a longer operating time (p=0.004) and a higher rate of subhepatic drains (p=0.014). Laparoscopic cholecystectomy is a safe and feasible procedure for patients with acute cholecystitis when the duration of symptoms is >3 days, however, a higher conversion rate is seen for acute chronic cholecystitis.