Early or delayed laparoscopic cholecystectomy in acute cholecystitis? Conclusions of a controlled trial.
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.
González-Rodríguez
Francisco J
FJ
Department of Surgery, Hospital Clinico Universitario, Medical School, Santiago de Compostela, Spain. fran.padroso@gmail.com
Paredes-Cotoré
Jesús P
JP
Pontón
Cristina
C
Rojo
Yago
Y
Flores
Enrique
E
Luis-Calo
Eva San
ES
Barreiro-Morandeira
Francisco
F
Punal
José A
JA
Fernández
Aquilino
A
Paulos
Ana
A
Santos
Fernando
F
Cainzos
Miguel
M
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