title: Early or delayed laparoscopic cholecystectomy in acute cholecystitis? Conclusions of a controlled trial.
abstract: OBJECTIVE
  Laparoscopic cholecystectomy is now accepted as being safe for acute cholecystitis. However, it has not become routine, because the exact timing and approach to the surgical management remains ill defined. This study evaluated the effect of timing of LC in patients with acute cholecystitis.
  
  
  METHODS
  Group 1, those patients who had LC for AC within 72 hours was compared with group 2, those who had LC for AC after 72 hours. Univariate logistic regression analysis and multivariate regression analysis were used to determine if any factors had a significant association with the complications, postoperative hospital stay, and conversion index. A value of p < 0.05 was considered statistically significant.
  
  
  RESULTS
  Comparing the two groups, the conversion rate to an open procedure was significantly less (7.8% versus 18.4%, P_0.02) in the early treated patients. Furthermore, postoperative hospitalization (6.5 versus 9.5 days, P 0.01), and complications (8.8% versus 17.7%, P _0.02) were significantly reduced in patients undergoing early laparoscopic cholecystectomy.
  
  
  CONCLUSIONS
  There is no advantage to delaying cholecystectomy for acute cholecystitis on the basis of outcomes in complications, rate of conversion to open surgery, and mean hospital stay. Thus, early cholecystectomy should be be the preferred surgical approach for patients with acute lithiasic cholecystitis.
authors.affiliation: Department of Surgery, Hospital Clinico Universitario, Medical School, Santiago de Compostela, Spain. fran.padroso@gmail.com
authors.forename: Francisco J
authors.initials: FJ
authors.lastname: González-Rodríguez
authors.forename: Jesús P
authors.initials: JP
authors.lastname: Paredes-Cotoré
authors.forename: Cristina
authors.initials: C
authors.lastname: Pontón
authors.forename: Yago
authors.initials: Y
authors.lastname: Rojo
authors.forename: Enrique
authors.initials: E
authors.lastname: Flores
authors.forename: Eva San
authors.initials: ES
authors.lastname: Luis-Calo
authors.forename: Francisco
authors.initials: F
authors.lastname: Barreiro-Morandeira
authors.forename: José A
authors.initials: JA
authors.lastname: Punal
authors.forename: Aquilino
authors.initials: A
authors.lastname: Fernández
authors.forename: Ana
authors.initials: A
authors.lastname: Paulos
authors.forename: Fernando
authors.initials: F
authors.lastname: Santos
authors.forename: Miguel
authors.initials: M
authors.lastname: Cainzos
mesh_terms: D000368:Aged; D000704:Analysis of Variance; D017081:Cholecystectomy, Laparoscopic / Q000379:methods*; D041881:Cholecystitis, Acute / Q000601:surgery*; D005260:Female; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology; D013030:Spain / Q000453:epidemiology; D013997:Time Factors; D016896:Treatment Outcome