The timing of surgery for cholecystitis: a review of 202 consecutive patients at a large municipal hospital.
BACKGROUND
Traditionally, cholecystectomy for cholecystitis is performed within 3 days of the onset of symptoms or after 5 weeks, allowing for resolution of the inflammatory response. This study reviewed the outcomes of cholecystectomy performed for patients with gallstone disease in the acute (n = 45), intermediate (n = 55), and delayed (n = 102) periods after the onset of symptoms.


METHODS
The medical records of 202 patients who underwent laparoscopic cholecystectomy at a large municipal hospital were reviewed retrospectively. The primary outcomes studied were length of hospital stay, conversion to open cholecystectomy, and complications.


RESULTS
There was no significant difference in the conversion rate (acute [18%] vs intermediate [20%] vs delayed [11%]) or complication rate (acute [16%] vs intermediate [9%] vs delayed [7%]) among the 3 groups. The delayed group had a significantly shorter length of hospital stay than the intermediate or acute group (3.1 +/- 3.8 vs 4.3 +/- 3.8 vs 1.7 +/- 2.1, respectively, P < .001).


CONCLUSIONS
Patients who present with acute symptoms of cholecystitis should undergo surgery during the same admission, regardless of the duration of symptoms.
Lee
Ann Y
AY
Department of Surgery, NYU Medical Center, NBV 15 North 1, 550 First Ave., New York, NY 10016, USA.
Carter
Joseph J
JJ
Hochberg
Mark S
MS
Stone
Alex M
AM
Cohen
Stuart L
SL
Pachter
H Leon
HL
D000208:Acute Disease; D000328:Adult; D000368:Aged; D002763:Cholecystectomy; D017081:Cholecystectomy, Laparoscopic / Q000009:adverse effects / Q000706:statistics & numerical data; D002764:Cholecystitis / Q000601:surgery*; D002908:Chronic Disease; D005260:Female; D006773:Hospitals, Municipal; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009519:New York City; D011237:Predictive Value of Tests; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome