title: Timing of laparoscopic cholecystectomy for mild and moderate acute cholecystitis.
abstract: OBJECTIVE
  The timing of a laparoscopic cholecystectomy (LC) for acute cholecystitis (AC) remains controversial. Traditionally, LC for AC is performed within 3 days. We designed this study so that the cut-off time of LC for AC was within 7 days of admission, based on severity.
  
  
  METHODS
  A total of 103 patients were divided into 2 groups: patients undergoing LC within 7 days of admission [early LC (ELC), n = 41] and patients undergoing LC between 8 days and 5 weeks of admission [delayed LC (DLC), n = 62]. The outcomes compared were complication rate, conversion rate, postoperative hospital days, and operation time. Statistical analyses were performed in mild, moderate and all AC cases. Results: Of all AC cases, successful LC was performed in 93 patients, and no significant difference was observed between the 2 groups. In DLC for moderate AC, percutaneous cholecystectomy (PC) with or without endoscopic nasal bile drainage (ENBD) was performed more frequently than ELC.
  
  
  CONCLUSIONS
  DLC had no advantage over ELC. ELC for AC is preferable in cost–effect. Even if the operation cannot be scheduled early, proper initial treatment, including percutaneous cholecystectomy with or without endoscopic nasal bile drainage for moderate AC, enables DLC a safe option.
authors.forename: Tomoaki
authors.initials: T
authors.lastname: Yoh
authors.forename: Ryuji
authors.initials: R
authors.lastname: Okamura
authors.forename: Yoshinari
authors.initials: Y
authors.lastname: Nobuto
authors.forename: Seidai
authors.initials: S
authors.lastname: Wada
authors.forename: Yuya
authors.initials: Y
authors.lastname: Nakamura
authors.forename: Tatsushi
authors.initials: T
authors.lastname: Kato
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Nakayama
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017081:Cholecystectomy, Laparoscopic / Q000009:adverse effects; D041881:Cholecystitis, Acute / Q000175:diagnosis / Q000601:surgery*; D004322:Drainage; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D010343:Patient Admission; D011183:Postoperative Complications / Q000209:etiology; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D013997:Time Factors; D061665:Time-to-Treatment; D016896:Treatment Outcome