Urgent laparoscopic cholecystectomy is the best management for biliary colic. A prospective randomized study of 75 cases.
OBJECTIVE
Delay of laparoscopic cholecystectomy after the diagnosis of biliary colic may increase the probability of recurrent emergency admission while awaiting elective cholecystectomy. The aim of this study was to compare the possible advantages and safety of urgent laparoscopic cholecystectomy (ULC) with elective laparoscopic cholecystectomy (ELC) in patients with biliary colic.


METHODS
Between 2001 and 2003, 75 patients with biliary colic were included in this study. The patients were classified into following two groups: patients who had ULC in 24 h were in group I (n = 28) and patients who had ELC (mean interval 4.22 +/- 1.42 months) were in group II (n = 35). Conversion to open cholecystectomy, operative time, postoperative hospital stay, costs, and complications were evaluated.


RESULTS
In group II, 9 patients made a total of 13 return visits to the emergency department with recurrent attacks of biliary colic or complications of gallstone disease. Mean operative time increased from 35.1 +/- 6.74 min for urgent laparascopic cholecystectomy to 49.9 +/- 6.12 min for ELC (p > 0.05) and hospital stay time increased from 1.06 +/- 0.4 to 2.31 +/- 2.36 days (p < 0.05). Conversion to open cholecystectomy increased from 0% in group I to 17.2% in group II (p < 0.05).


CONCLUSIONS
ULC for biliary colic may be the most medically efficacious and cost-effective treatment.
Salman
Bülent
B
Hepato-Pancreato-Biliary Surgery Unit, Department of General Surgery, Gazi University Medical School, Ankara, Turkey. bsalman97@yahoo.com
Yüksel
Osman
O
Irkörücü
Oktay
O
Akyürek
Nusret
N
Tezcaner
Tugan
T
Doğan
Ibrahim
I
Erdem
Ozlem
O
Tatlicioğlu
Ertan
E
D000328:Adult; D001660:Biliary Tract Diseases / Q000601:surgery*; D017081:Cholecystectomy, Laparoscopic; D002764:Cholecystitis / Q000601:surgery; D003085:Colic / Q000601:surgery*; D017558:Elective Surgical Procedures; D004632:Emergency Medical Services; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D010359:Patient Readmission / Q000706:statistics & numerical data; D011446:Prospective Studies; D013997:Time Factors