Operative outcome and patient satisfaction in early and delayed laparoscopic cholecystectomy for acute cholecystitis.

Aly Saber,Emad N Hokkam

doi:10.1155/2014/162643

Aly Saber, Emad N Hokkam

Open Access

https://doi.org/10.1155/2014/162643

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Abstract

Introduction. Early laparoscopic cholecystectomy is usually associated with reduced hospital stay, sick leave, and health care expenditures. Early diagnosis and treatment of acute cholecystitis reduce both mortality and morbidity and the accurate diagnosis requires specific diagnostic criteria of clinical data and imaging studies. Objectives. To compare early versus delayed laparoscopic cholecystectomy regarding the operative outcome and patient satisfaction. Patients and Methods. Patients with acute cholecystitis were divided into two groups, early (A) and delayed (B) cholecystectomy. Diagnosis of acute cholecystitis was confirmed by clinical examination, laboratory data, and ultrasound study. The primary end point was operative and postoperative outcome and the secondary was patient's satisfaction. Results. The number of readmissions in delayed treatment group B was three times in 10% of patients, twice in 23.3%, and once in 66.7% while the number of readmissions was once only in patients in group A and the mean total hospital stays were higher in group B than in group A. The overall patient's satisfaction was 92.66 ± 6.8 in group A compared with 75.34 ± 12.85 in group B. Conclusion. Early laparoscopic cholecystectomy resulted in significant reduction in length of hospital stay and accepted rate of operative complications and conversion rates when compared with delayed techniques.

Highlights

Laparoscopic cholecystectomy is usually associated with reduced hospital stay, sick leave, and health care expenditures
Several studies have shown that early laparoscopic cholecystectomy conducted within 72–96 hours after the onset of symptoms is usually associated with advantages such as reduced hospital stay, sick leave, and health care expenditures and no disadvantages with regard to mortality and morbidity [1]
Grades and severity of acute cholecystitis were traced in both groups according to the clinical finding, laboratory data, and imaging studies

Summary

Introduction

Laparoscopic cholecystectomy is usually associated with reduced hospital stay, sick leave, and health care expenditures. Diagnosis and treatment of acute cholecystitis reduce both mortality and morbidity and the accurate diagnosis requires specific diagnostic criteria of clinical data and imaging studies. Laparoscopic cholecystectomy resulted in significant reduction in length of hospital stay and accepted rate of operative complications and conversion rates when compared with delayed techniques. Several studies have shown that early laparoscopic cholecystectomy conducted within 72–96 hours after the onset of symptoms is usually associated with advantages such as reduced hospital stay, sick leave, and health care expenditures and no disadvantages with regard to mortality and morbidity [1]. Diagnosis and treatment of patients with acute cholecystitis reduce both mortality and morbidity and the accurate diagnosis requires specific diagnostic criteria of clinical data and imaging studies [2]. The typical ultrasound image of acute cholecystitis demonstrates gallbladder swelling, wall thickening with sonolucent layers, massive debris, and the stone impaction in the cystic duct [3]

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Conclusion