The Optimal Timing of Laparoscopic Cholecystectomy in Acute Cholecystitis: A Single-Center Study

Abstract

Introduction Early laparoscopic cholecystectomy (ELC) is a treatment option for acute cholecystitis (AC). However, the timing of ELC is controversial. Delayed laparoscopic cholecystectomy (DLC) continues to be a common practice. This study aims to determine the optimal timing of ELC in AC. Materials and methods Patients who underwent surgery for AC between 2014 and 2020 were divided into three groups: immediate laparoscopic cholecystectomy (ILC), prolonged ELC (pELC), and DLC. The demographic, laboratory, radiological findings, and postoperative results of all patients were retrospectively reviewed. Results The study included 178 patients, with 63 in the ILC group, 27 in the pELC group, and 88 in the DLC group. Postoperative outcomes, excluding hospital stay, were similar between the groups. The total hospital stay was significantly longer in the pELC and DLC groups (p<0.05). In addition, postoperative hospital stay was longer in the pELC group (p<0.05), and 17.7% of the patients who waited for delayed surgery experienced recurrent attacks during the interval period. Conclusion ILC is recommended in AC to minimize hospital stays.

Symptom Duration and Surgeon Volume: Impact on Early Laparoscopic Cholecystectomy for Acute Cholecystitis

“…Early studies reported high mortality rates and bile duct injuries associated with LC [3]. However, as experience in laparoscopic surgery increased over the years, early laparoscopic cholecystectomy (ELC) has demonstrated superiority over delayed laparoscopic cholecystectomy, as it reduced hospital stays and had similar postoperative outcomes [4]. Currently, LC is considered the gold standard for treating AC [5].…”

“…1 Pearson Chi-Square test,2 Student t-test,3 Mann Whitney U test,4 Fisher's exact test, * p<0.05 significance, CCI: Charlson comorbidity index, ASA: American Society of Anesthesiologists, WBC: White blood cell, CRP: C-reactive protein, AST: Aspartate aminotransferase, ALT: Alanine aminotransferase, ALP: Alkaline phosphatase, GGT: Gamma-glutamyl transferase, TBIL: Total bilirubin, DBIL: Direct bilirubin, GB: Gallbladder…”