title: Is early laparoscopic cholecystectomy a safe procedure in patients when the duration of acute cholecystitis is more than three days?
abstract: OBJECTIVE
  The role of laparoscopic cholecystectomy for patients with acute cholecystitis and symptoms for >3 days is debated. Our purpose was to compare the results of laparoscopic cholecystectomy in patients with acute cholecystitis and symptoms for ≤ 3 days and >3 days.
  
  
  METHODS
  Sixty patients with acute cholecystitis had a laparoscopic cholecystectomy performed by the same surgeon. There were 39 patients in the short group (symptoms ≤ 3 days) and 21 patients in the long group (symptoms >3 days). Demographic data, surgical findings and clinical results were analyzed.
  
  
  RESULTS
  There were no significant differences in age, gender, comorbidities, abnormal liver function tests, white bile, gallbladder empyema, blood loss, conversion rate, postoperative hospital stay or complication rates between the groups. The mean duration of acute cholecystitis was 1.9 days in the short group and 5.3 days in the long group (p<0.0001). The long group had a longer operating time (p=0.004) and a higher rate of subhepatic drains (p=0.014).
  
  
  CONCLUSIONS
  Laparoscopic cholecystectomy is a safe and feasible procedure for patients with acute cholecystitis when the duration of symptoms is >3 days, however, a higher conversion rate is seen for acute chronic cholecystitis.
authors.affiliation: Department of Surgery, National Taiwan University Hospital, Taiwan.
authors.forename: Jin-Ming
authors.initials: JM
authors.lastname: Wu
authors.forename: Yao-Ming
authors.initials: YM
authors.lastname: Wu
authors.forename: Chih-Yuan
authors.initials: CY
authors.lastname: Lee
authors.forename: Hsiu-Po
authors.initials: HP
authors.lastname: Wang
authors.forename: Ming-Tsan
authors.initials: MT
authors.lastname: Lin
mesh_terms: D000328:Adult; D000368:Aged; D016009:Chi-Square Distribution; D017081:Cholecystectomy, Laparoscopic / Q000009:adverse effects*; D041881:Cholecystitis, Acute / Q000601:surgery*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D061214:Patient Safety; D018579:Patient Selection; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013624:Taiwan; D013997:Time Factors; D016896:Treatment Outcome