Early versus delayed laparoscopic cholecystectomy for acute cholecystitis: a prospective, randomized study.
We aimed to compare the clinical outcome and cost of early versus delayed laparoscopic cholecystectomy for acute cholecystitis. Sixty patients with acute cholecystitis were randomized into early (within 24 hours of admission) or delayed (after 6-8 weeks of conservative treatment) laparoscopic cholecystectomy groups. There was no significant difference between study groups in terms of operation time and rates for conversion to open cholecystectomy. On the other hand, total hospital stay was longer (5.2 ± 1.40 versus 7.8 ± 1.65 days; P = 0.04) and total costs were higher (2500.97 ± 755.265 versus 3713.47 ± 517.331 Turkish Lira; P = 0.03) in the delayed laparoscopic cholecystectomy group. Intraoperative and postoperative complications were recorded in 8 patients in the early laparoscopic cholecystectomy group, whereas no complications occurred in the delayed laparoscopic cholecystectomy group (P = 0.002). Despite intraoperative and postoperative complications being associated more with early laparoscopic cholecystectomy compared with delayed intervention, early laparoscopic cholecystectomy should be preferred for treatment of acute cholecystitis because of its advantages of shorter hospital stay and lower cost.
1 Department of General Surgery, Atatürk Training and Research Hospital, Ankara, Turkey.
Alper Bilal
AB
Ozkardeş
Mehmet
M
Tokaç
Ersin Gürkan
EG
Dumlu
Birkan
B
Bozkurt
Ahmet Burak
AB
Ciftçi
Fahri
F
Yetişir
Mehmet
M
Kılıç
D000328:Adult; D000368:Aged; D017081:Cholecystectomy, Laparoscopic / Q000191:economics / Q000379:methods*; D041881:Cholecystitis, Acute / Q000191:economics / Q000601:surgery*; D005260:Female; D017721:Hospital Costs / Q000706:statistics & numerical data; D006801:Humans; D007902:Length of Stay / Q000191:economics / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000191:economics / Q000453:epidemiology / Q000209:etiology; D011446:Prospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D014421:Turkey