Early Versus Delayed Laparoscopic Cholecystectomy in Acute Cholecystitis

Choi, Sung Il; Lee, Sang Mok; Ko, Young Gwan; Koh, Suck Hwan; Hong, Sung Wha; Joo, Hoong Zae

Abstract

PURPOSE: The laparoscopic cholecystectomy has increasingly been accepted as the procedure of choice for treatment of symptomatic gall stones and chronic cholecystitis. However, its role and its timing in the management of patients with acute cholecystitis remain controversial. This retrospective study was undertaken to compare on early laparoscopic cholecystectomy with a delay one for patients with acute cholecystitis.
METHODS
Between January 1995 and June 1999, 15 patients were operated on within 72 hours of symptom onset. Those patients were classified as the early laparoscopic cholecystectomy group. The 18 patients who underwent a delayed laparoscopic cholecystectomy after a percutaneous transhepatic cholecystostomy (PTCS) and conservative management were classified as the delayed laparoscopic cholecystectomy group. RESULTS: No significant differences were seen in the conversion rate (1 case in the delayed group), the operation time (early group 107.3 min., delayed group 118.6 min.), postoperative complications (early group 20.0%, delayed group 16.7%), and the postoperative hospital stay (early group 4.7 days, delayed group 7.1 days). The early group had significantly more frequent operation modifications and decreased total hospital stays than the delayed group: 86.7% and 7.0 days, for the early group and 44.4% and 22.8 days for the delayed group. CONCLUSION: Early laparoscopic cholecystectomy for acute cholecystitis did not increase the operation time, the morbidity, or the conversion rate. Although this study was not a randomized study and the sample size was small, an early laparoscopic cholecystectomy seems to be safe and feasible for patients with acute cholecystitis, having the benefit of a decreased total hospital stay.