Timing of laparoscopic cholecystectomy for acute cholecystitis with cholecystolithiasis.
OBJECTIVE
Laparoscopic cholecystectomy is now used in the treatment of acute cholecystitis. The aim of this study is to define the optimal timing for laparoscopic cholecystectomy treated with cholecystolithiasis in patients with acute cholecystitis.


METHODS
A retrospective analysis of 73 patients with acute cholecystolithiasis who were treated by either early laparoscopic cholecystectomy within 72 hours after initial onset or initial conservative treatment followed by delayed laparoscopic cholecystectomy 4 days later.


RESULTS
There were 31 patients in the early group and 42 in the delayed group. There was no significant difference in the rate of conversion from laparoscopic to open surgery (6.4% vs. 20.0%), postoperative complications. However the early group had significantly shorter operation time (103 vs. 135 min, p<0.01) and shorter postoperative hospital stay (6.2 vs. 9.6 days, p<0.01).


CONCLUSIONS
We advocate early laparoscopic cholecystectomy within 72 hours of onset of symptoms to decrease conversion rates from laparoscopic to open surgery. This decreased conversion rate results in decreasing the length of operation time and postoperative and total hospital stay.
Uchiyama
Kazuhisa
K
Second Department of Surgery, Wakayama Medical University, School of Medicine, Wakayama, Japan.
Onishi
Hironobu
H
Tani
Masaji
M
Kinoshita
Hiroyuki
H
Ueno
Masaki
M
Yamaue
Hiroki
H
D000208:Acute Disease; D000328:Adult; D000368:Aged; D017081:Cholecystectomy, Laparoscopic; D002764:Cholecystitis / Q000601:surgery*; D041761:Cholecystolithiasis / Q000150:complications*; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome