title: Laparoscopic cholecystectomy in acute cholecystitis: support for an early interval surgery.
abstract: OBJECTIVE
  Although laparoscopic cholecystectomy is advocated for acute cholecystitis, debate still exists about its optimal timing. This retrospective study compares the outcome of laparoscopic cholecystectomy within versus later than 5 days of onset of symptoms in patients with acute cholecystitis.
  
  
  METHODS
  One hundred thirty six patients with acute cholecystitis grade I or II were included in the study and divided in two groups. Group 1 received surgery within 5 days of symptoms and group 2 received conservative therapy and delayed surgery after 6 weeks.
  
  
  RESULTS
  Group 1 and 2 consisted of 100 and 36 patients respec- tively. Because of failure of conservative therapy 5 patients of group 2 had surgery before 6 weeks. The remaining 31 patients underwent surgery after 6 weeks. Preoperative ERCP was indicated in 2 and 11 patients in groups 1 and 2 respectively (p < 0.001). The median total hospital stay was 3.0 days for group 1 and 11.0 days for group 2 (p < 0.001). In terms of operation time, conversion rates, intraoperative cholangiography, postoperative ERCP, morbidity or mortality both groups were comparable (p > 0.05).
  
  
  CONCLUSIONS
  Laparoscopic cholecystectomy can be performed safely within 5 days after the onset of symptoms in patients with acute cholecystitis. Because of shortened total hospital stay and risk of failure of conservative therapy, early laparoscopic cholecystectomy should be favored.
authors.forename: A
authors.initials: A
authors.lastname: Croo
authors.forename: E
authors.initials: E
authors.lastname: De Wolf
authors.forename: K
authors.initials: K
authors.lastname: Boterbergh
authors.forename: A
authors.initials: A
authors.lastname: Vanlander
authors.forename: H
authors.initials: H
authors.lastname: Peeters
authors.forename: R I
authors.initials: RI
authors.lastname: Troisi
authors.forename: F
authors.initials: F
authors.lastname: Berrevoet
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017081:Cholecystectomy, Laparoscopic; D041881:Cholecystitis, Acute / Q000175:diagnosis* / Q000601:surgery*; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult