title: Determination of optimal operation time for the management of acute cholecystitis: a clinical trial.
abstract: BACKGROUND
  Although all studies have reported that laparoscopic cholecystectomy (LC) is a safe and effective treatment for acute cholecystitis, the optimal timing for the procedure is still the subject of some debate.
  
  
  OBJECTIVE
  This retrospective analysis of a prospective database was aimed at comparing early with delayed LC for acute cholecystitis.
  
  
  METHODS
  The LC was performed in 165 patients, of whom 83 were operated within 72 h of admission (group 1) and 82 patients after 72 h (group 2) with acute cholecystitis between January 2012 and August 2013. All data were collected prospectively and both groups compared in terms of age, sex, fever, white blood count count, ultrasound findings, operation time, conversion to open surgery, complications and mean hospital stay.
  
  
  RESULTS
  The study included 165 patients, 53 men and 112 women, who had median age 54 (20-85) years. The overall conversion rate was 27.9%. There was no significant difference in conversion rates (21% vs. 34%) between groups (p = 0.08). The operation time (116 min vs. 102 min, p = 0.02) was significantly increased in group 1. The complication rates (9% vs. 18%, p = 0.03) and total hospital stay (3.8 days vs. 7.9 days, p = 0.001) were significantly reduced in group 1.
  
  
  CONCLUSIONS
  Early LC within 72 h of admission reduces complications and hospital stay and is the preferred approach for acute cholecystitis.
authors.affiliation: Department of Gastroenterology Surgery, Izmir Training and Research Hospital, Izmir, Turkey.
authors.forename: Erkan
authors.initials: E
authors.lastname: Oymaci
authors.affiliation: Department of Gastroenterology Surgery, Izmir Training and Research Hospital, Izmir, Turkey.
authors.forename: Ahmet Deniz
authors.initials: AD
authors.lastname: Ucar
authors.affiliation: Department of Gastroenterology Surgery, Izmir Training and Research Hospital, Izmir, Turkey.
authors.forename: Savas
authors.initials: S
authors.lastname: Yakan
authors.affiliation: Department of Gastroenterology Surgery, Izmir Training and Research Hospital, Izmir, Turkey.
authors.forename: Erdem Baris
authors.initials: EB
authors.lastname: Carti
authors.affiliation: Department of Gastroenterology Surgery, Izmir Training and Research Hospital, Izmir, Turkey.
authors.forename: Ali
authors.initials: A
authors.lastname: Coskun
authors.affiliation: Department of Gastroenterology Surgery, Izmir Training and Research Hospital, Izmir, Turkey.
authors.forename: Nazif
authors.initials: N
authors.lastname: Erkan
authors.affiliation: Department of Surgery, Bozyaka Training and Research Hospital, Izmir, Turkey.
authors.forename: Mehmet
authors.initials: M
authors.lastname: Yildirim
keywords: acute cholecystitis; laparoscopic cholecystectomy; postoperative complications
references.citation: Arch Surg. 2008 Jun;143(6):533-7
references.pmid: 18559744
references.citation: Ann Surg. 1991 Jun;213(6):655-62; discussion 662-4
references.pmid: 1828140
references.citation: Surg Laparosc Endosc Percutan Tech. 2005 Feb;15(1):1-8
references.pmid: 15714147
references.citation: Surg Endosc. 2004 Sep;18(9):1323-7
references.pmid: 15803229
references.citation: J Gastrointest Surg. 2003 Jul-Aug;7(5):642-5
references.pmid: 12850677
references.citation: J Long Term Eff Med Implants. 2005;15(3):329-38
references.pmid: 16022643
references.citation: Br J Surg. 2005 Jan;92(1):76-82
references.pmid: 15521078
references.citation: J Hepatobiliary Pancreat Surg. 2007;14(1):78-82
references.pmid: 17252300
references.citation: Am J Surg. 2006 Dec;192(6):756-61
references.pmid: 17161089
references.citation: Best Pract Res Clin Gastroenterol. 2006;20(6):981-96
references.pmid: 17127183
references.citation: Arch Surg. 2004 May;139(5):476-81; discussion 481-2
references.pmid: 15136346
references.citation: J Hepatobiliary Pancreat Surg. 2002;9(5):538-42
references.pmid: 12541036
references.citation: World J Surg. 1996 Jan;20(1):43-8; discussion 48-9
references.pmid: 8588411
references.citation: Surg Endosc. 2007 May;21(5):805-9
references.pmid: 17180290
references.citation: Surg Endosc. 2006 May;20(5):806-8
references.pmid: 16544075
references.citation: Hepatogastroenterology. 2009 Jan-Feb;56(89):26-8
references.pmid: 19453022
references.citation: Am Surg. 2000 Sep;66(9):896-900
references.pmid: 10993625
references.citation: Ann Surg. 1998 Apr;227(4):461-7
references.pmid: 9563529
references.citation: Am J Gastroenterol. 2004 Jan;99(1):147-55
references.pmid: 14687156
references.citation: Int J Surg. 2012;10(5):250-8
references.pmid: 22525382
references.citation: Surg Endosc. 2000 Apr;14(4):358-61
references.pmid: 10790555
references.citation: JSLS. 2008 Jul-Sep;12(3):282-7
references.pmid: 18765053
references.citation: J Hepatobiliary Pancreat Surg. 2006;13(5):409-15
references.pmid: 17013715