title: Advantages of early cholecystectomy in clinical practice of a terciary care center.
abstract: BACKGROUND
  Despite a number of studies show the superiority of early over delayed cholecystectomy in the treatment of acute cholecystitis, there is still controversy over the time for intervention. This study aimed to assess the use of early versus delayed cholecystectomy for the treatment of acute cholecystitis in terms of complications, conversion to open surgery and mean hospital stay.
  
  
  METHODS
  We collected patients with acute cholecystitis treated at a referral center for a year, and retrospectively analyzed the chosen therapeutic approach, the percentage of conversion of early cholecystectomy to open surgery, appearance of surgical complications, and mean hospital stay.
  
  
  RESULTS
  The study included 117 patients, 44 women and 73 men, who had a mean age of 67.36+/-15.74 years. Early cholecystectomy was chosen in 31 (26.5%) and delayed cholecystectomy in 74 patients (63.2%). Of the 74 patients, 28 (37.8%) required emergency performance of delayed cholecystectomy, and 19 (25.7%) had not undergone surgery by the end of the study. While no differences were observed between early and delayed cholecystectomy in terms of surgical complications and conversion to open surgery, mean hospital stay was nevertheless significantly shorter in the early versus the delayed cholecystectomy group (8.32+/-4.98 vs 15.96+/-8.89 days).
  
  
  CONCLUSIONS
  Under the routine working conditions of a hospital that is neither specially dedicated to the surgical treatment of acute cholecystitis nor provided with specific management guidelines, early cholecystectomy can reduce the hospital stay without increase of the conversion rate or complications.
authors: Health Research Institute, San Carlos Clinical Hospital, Department of Medicine, School of Medicine, Complutense University, Madrid 28040, Spain. marta.barcelo@yahoo.es
authors: Marta
authors: M
authors: Barcelo
authors: Dulce Maria
authors: DM
authors: Cruz-Santamaria
authors: Cristina
authors: C
authors: Alba-Lopez
authors: Maria Jose
authors: MJ
authors: Devesa-Medina
authors: Manuel
authors: M
authors: Diaz-Rubio
authors: Enrique
authors: E
authors: Rey
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D017081:Cholecystectomy, Laparoscopic / Q000706:statistics & numerical data*; D041881:Cholecystitis, Acute / Q000453:epidemiology* / Q000601:surgery*; D061887:Conversion to Open Surgery / Q000706:statistics & numerical data; D017558:Elective Surgical Procedures / Q000706:statistics & numerical data; D004632:Emergency Medical Services / Q000706:statistics & numerical data; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology; D012017:Referral and Consultation / Q000706:statistics & numerical data; D012189:Retrospective Studies; D013030:Spain / Q000453:epidemiology; D062606:Tertiary Care Centers / Q000706:statistics & numerical data*; D013997:Time Factors; D016896:Treatment Outcome