title: Is there an optimal time for laparoscopic cholecystectomy in acute cholecystitis?
abstract: BACKGROUND
  Laparoscopic cholecystectomy (LC) is safe in acute cholecystitis, but the exact timing remains ill-defined. This study evaluated the effect of timing of LC in patients with acute cholecystitis.
  
  
  METHODS
  Prospective data from the hospital registry were reviewed. All patients admitted with acute cholecystitis from June 1994 to January 2004 were included in the cohort.
  
  
  RESULTS
  Laparoscopic cholecystectomy was attempted in 1,967 patients during the study period; 80% were women, mean patient age was 44 years (range, 20-73 years). Of the 1,967 LC procedures, 1,675 were successful, and 292 were converted to an open procedure (14%). Mean operating time for LC was 1 h 44 min (SD +/- 50 min), versus 3 h 5 min (SD +/- 79 min) when converted to an open procedure. Average postoperative length of stay was 1.89 days (+/- 2.47 days) for the laparoscopic group and 4.3 days (+/- 2.2 days) for the conversion group. No clinically relevant differences regarding conversion rates, operative times, or postoperative length of stay were found between patients who were operated on within 48 h compared to those patients who were operated on post-admission days 3-7.
  
  
  CONCLUSIONS
  The timing of laparoscopic cholecystectomy in patients with acute cholecystitis has no clinically relevant effect on conversion rates, operative times, or length of stay.
authors.affiliation: Division of Trauma, University of Miami-Miller School of Medicine, P.O. Box 016960 (D-40), Miami, Florida 33101, USA.
authors.forename: D
authors.initials: D
authors.lastname: Soffer
authors.forename: L H
authors.initials: LH
authors.lastname: Blackbourne
authors.forename: C I
authors.initials: CI
authors.lastname: Schulman
authors.forename: M
authors.initials: M
authors.lastname: Goldman
authors.forename: F
authors.initials: F
authors.lastname: Habib
authors.forename: R
authors.initials: R
authors.lastname: Benjamin
authors.forename: M
authors.initials: M
authors.lastname: Lynn
authors.forename: P P
authors.initials: PP
authors.lastname: Lopez
authors.forename: S M
authors.initials: SM
authors.lastname: Cohn
authors.forename: M G
authors.initials: MG
authors.lastname: McKenney
mesh_terms: D000328:Adult; D000368:Aged; D017081:Cholecystectomy, Laparoscopic; D041881:Cholecystitis, Acute / Q000601:surgery*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012042:Registries; D013997:Time Factors; D016896:Treatment Outcome