EARLY VERSUS DELAYED LAPAROSCOPIC CHOLECYSTECTOMY FOR ACUTE CHOLECYSTITIS

Authors

  • Sadaf Khalid
  • Zahid Iqbal
  • Afsar Ali Bhatti

Abstract

Background: Laparoscopic cholecystectomy is considered the gold standard for the management of acute cholecystitis but controversy surrounds the timings of the surgery. Studies are available favouring both early and delayed laparoscopic cholecystectomy. The objective of this study was to compare early versus delayed laparoscopic cholecystectomy for acute cholecystitis. Methods: This quasi-experimental study included 180 patients irrespective of their age and sex presented at department of Surgery, Lahore General Hospital between January to December 2014 with a diagnosis of acute cholecystitis were assigned randomly to early laparoscopic cholecystectomy within 24 h of admission or to initial conservative treatment followed by delayed laparoscopic cholecystectomy, 6-12 weeks later.  Results: The mean operating time was 64.32 min vs. 58.24 min in the delayed group, conversion rate (early 15.5% vs. delayed 14.4%). The mean postoperative hospital stay was 1.67 days in the earlier group and 4.38 days in the delayed group. Overall mortality was zero. Conclusion: Early laparoscopic cholecystectomy for acute cholecystitis is safe, offering economic benefit of much shorter hospital stay and quick recovery.

Keywords: Acute cholecystitis; Laparoscopic cholecystectomy; Early cholecystectomy

Author Biography

Sadaf Khalid

SURGICAL UNIT 11

FINAL YEAR RESIDENT GENERAL SURGERY

References

Cox MR, Wilson TG, Luck AJ, Jeans PL, Padbury RT, Toouli J. Laparoscopic cholecystectomy for acute inflammation of the gallbladder. Ann Surg 1993;218(5):630-4.

Miller RE, Kimmelsteil FM. Laparoscopic cholecystectomy for acute cholecystitis. Surg Endosc 1993;7(4):296-9.

Weisen SM, Unger SW, Barkin JS, Edelman DS, Scott JS, Unger HM. Laparoscopic cholecystectomy: the procedure of choice for acute cholecystitis. Am J Gastroenterol 1992;88(3):334-7.

Johansson M, Thune A, Blomqvist A, Nelvin L, Lundell L. Management of acute cholecystitis in the laparoscopic era: results of a prospective randomized clinical trial. J Gastrointest Surg 2003;7(5):642-5.

National institutes of Health. Consensus Development Conference Statement on gallstones and Laparoscopic cholecystectomy. Am J Surg 1993;165(4):390-8.

Va Der Linden W, Edlund G. Early versus Delayed cholecystectomy: the effect of a change in management. Br J Surg 1981;68(11):753-7.

Ambe P, Esfahani BJ, Tasci I, Christ H, Kohler L. Is laparoscopic cholecystectomy more challenging in male patients? Surg Endosc Interv Tech 2011;25(7);2236-40.

Lo CM, Liu CL, Fan ST, Lai EC, Wong J. Prospective randomized study of early versus delayed laparoscopic cholecystectomy for acute cholecystitis. Ann Surg 1998;227(4):461-7.

Kum CK, Goh PM, Isaac JR, Tekant Y, Ngoi SS. Laparoscopic cholecystectomy for acute cholecystitis. Br J Surg 1994;81(11):1651-4.

Graves Jr HA, Ballinger JF, Anderson WJ. Appraisal of laparoscopic cholecystectomy. Ann Surg 1991;213(6):655-71.

Kiviluoto T, Sirén J, Luukkonen P, Kivilaakso E. Randomized trial of laparoscopic versus open cholecystectomy for acute and gangrenous cholecystitis. Lancet 1998;351(9099):321-5.

Wilson RG, Macintyre IMC, Nixon SJ, Saunders JH, Varma JS, King PM. Laparoscopic cholecystectomy as a safe and effective treatment for severe acute cholecystitis. BMJ 1992;305(6850):394-6.

Unger SW, Rosenbaum G, Unger HM, Edelman DS. A comparison of laparoscopic and open treatment of acute cholecystitis. Surg Endosc 1993;7(5):408-11.

Gutt CN, Encke J, Köninger J, Harnoss JC, Weigand K, Kipfmüller K, et al. Acute cholecystitis: early versus delayed cholecystectomy, a multicenter randomized trial (ACDC study. Ann Surg 2013;258(3):385-93.

Kolla SB, Aggarwal S, Kumar A, Kumar R, Chumber S, Parshad R, et al. Early vs delayed laparoscopic cholecystectomy for acute cholecystitis: a prospective randomized trial. Surg Endosc 2004;18(9):1323-7.

Chandler CF, Lane JS, Ferguson P, Thompson JE, Ashley SW. Prospective evaluation of early versus delayed laparoscopic cholecystectomy for treatment of acute cholecystitis. Am Surg 2000;66(9):896-900.

Koo KP, Thirlby RC. Laparoscopic cholecystectomy in acute cholecystitis. What is the optimal timing for operation? Arch Surg 1996;131:540-4.

Lai PB, Kwong KH, Leung KL, Kwok SP, Chan AC, Chung SC, et al. Randomized trial of early versus delayed laparoscopic cholecystectomy for acute cholecystitis. Br J Surg 1998;85(6):764-7.

Rattner DW, Ferguson C, Warshaw AL. Factors associated with successful laparoscopic cholecystectomy for acute cholecystitis. Ann Surg 1993;217(3):233-6.

Zhu B, Zhang Z, Wang Y, Gong K, Lu Y, Zhang N. Comparision of laparoscopic cholecystectomy for acute cholecystitis within and beyond 72 h of symptom onset during emergency admissions. World J Surg 2012;36(11):2654-8.

Agrawal R, Sood KC, Agrawal B. Evaluation of Early vs Delayed Laparoscopic Cholecystectomy in acute cholecystitis. Surg Res Pract 2015;349801.

Verma S, Agarwal PN, Bali RS, Singh R, Talwar N. Early versus Delayed Laparoscopic Cholecystectomy for Acute Cholecystitis: A Prospective Randomized Trial. ISRN Minim Invasive Surg 2013;2013:1-3.

González-Rodríguez FJ, Paredes-Cotoré JP, Pontón C, Rojo Y, Flores E, Luis-Calo ES, et al. Early or delayed laparoscopic cholecystectomy in acute cholecystitis? Conclusions of a controlled trial. Hepatogastroenterology 2009;56(89):11-6.

Downloads

Published

2017-10-15

How to Cite

Khalid, S., Iqbal, Z., & Bhatti, A. A. (2017). EARLY VERSUS DELAYED LAPAROSCOPIC CHOLECYSTECTOMY FOR ACUTE CHOLECYSTITIS. Journal of Ayub Medical College Abbottabad, 29(4), 570–573. Retrieved from https://jamc.ayubmed.edu.pk/jamc/index.php/jamc/article/view/3285