Operative timing of laparoscopic cholecystectomy for acute cholecystitis in a Japanese institute.
OBJECTIVE
In patients with acute cholecystitis who cannot undergo early laparoscopic cholecystectomy (within 72 hours), 6 weeks to 12 weeks after onset is widely considered the optimal timing for delayed laparoscopic cholecystectomy. However, there has been no  clear consensus about it. We aimed to determine optimal timing for delayed laparoscopic cholecystectomy for acute cholecystitis.


METHODS
Medical records of 100 patients who underwent standard laparoscopic cholecystectomy were reviewed retrospectively. Patients were divided into  group 1, patients undergoing laparoscopic cholecystectomy within 72 hours of onset; group 2, between 4 days to 14 days; group 3, between 3 weeks to 6 weeks; group 4, >6 weeks.


RESULTS
No significant differences existed between groups in conversion rate to open surgery, operation  time, blood loss, or postoperative morbidity, and hospital stay. However, total hospital stay in groups 1 and 2 was significantly shorter than that in groups 3 and 4 (P<.01). In addition, the total hospital stay in group 3 was also significantly shorter than that in group 4 (P<.01).


CONCLUSIONS
Best timing of laparoscopic cholecystectomy for acute cholecystitis may be within 72 hours, and the delayed timing of laparoscopic cholecystectomy in patients who cannot undergo early laparoscopic cholecystectomy is probably as soon as possible after they can tolerate laparoscopic  cholecystectomy.
Department of Surgery I, Oita University Faculty of Medicine, Oita, Japan. ohta@med.oita-u.ac.jp
Masayuki
M
Ohta
Yukio
Y
Iwashita
Kazuhiro
K
Yada
Tadashi
T
Ogawa
Seiichiro
S
Kai
Tetsuya
T
Ishio
Kohei
K
Shibata
Toshifumi
T
Matsumoto
Toshio
T
Bandoh
Seigo
S
Kitano
D000328:Adult; D017081:Cholecystectomy, Laparoscopic; D041881:Cholecystitis, Acute / Q000175:diagnosis / Q000453:epidemiology / Q000601:surgery*; D015897:Comorbidity; D005260:Female; D006801:Humans; D007564:Japan; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies