Timing of laparoscopic cholecystectomy for acute cholecystitis: a prospective non randomized study.
OBJECTIVE
To study the timing of laparoscopic cholecystectomy for patients with acute cholecystitis.


METHODS
Between January 2002 and December 2005, all American Society of Anesthesiologists classification (ASA) I, II and III patients with acute cholecystitis were treated laparoscopically during the urgent (index) admission. The patients were divided into three groups according to the timing of surgery: (1) within the first 3 d, (2) between 4 and 7 d and (3) beyond 7 d from the onset of symptoms. The impact of timing on the conversion rate, morbidity and postoperative hospital stay was studied.


RESULTS
One hundred and twenty-nine patients underwent laparoscopic cholecystectomy for acute cholecystitis during the index admission. Thirty six were assigned to group 1, 58 to group 2, and 35 to group 3. The conversion rate and morbidity for the whole cohort of patients were 4.6% and 10.8%, respectively. There was no significant difference in the conversion rate, morbidity and postoperative hospital stay between the three groups.


CONCLUSIONS
Laparoscopic cholecystectomy for acute cholecystitis during the index admission is safe, regardless of the time elapsed from the onset of symptoms. This policy can result in an overall shorter hospitalization.
Tzovaras
George
G
Department of Surgery, University of Thessaly School of Medicine, University Hospital of Larissa, 19 Agorogianni A. Street, Larissa 41335, Greece. gtzovaras@hotmail.com
Zacharoulis
Dimitris
D
Liakou
Paraskevi
P
Theodoropoulos
Theodoros
T
Paroutoglou
George
G
Hatzitheofilou
Constantine
C
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017081:Cholecystectomy, Laparoscopic / Q000379:methods*; D041881:Cholecystitis, Acute / Q000601:surgery*; D015897:Comorbidity; D005260:Female; D006801:Humans; D007813:Laparotomy; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012720:Severity of Illness Index; D016019:Survival Analysis; D013997:Time Factors