title: Feasibility and Safety of Urgent Laparoscopic Cholecystectomy for Acute Cholecystitis After 4 Days from Symptom Onset.
abstract: BACKGROUND
  It is preferable to perform laparoscopic cholecystectomy for acute cholecystitis in the acute phase, within 72 h of symptom onset. The feasibility and safety of performing urgent laparoscopic cholecystectomy in the late phase (4-7 days after symptom onset) are unclear. The aim of this study was to clarify the feasibility and safety of late phase urgent laparoscopic cholecystectomy.
  
  
  METHODS
  Between 2005 and 2014, 233 patients underwent urgent laparoscopic cholecystectomy for acute cholecystitis within 7 days. We compared clinical features and perioperative outcomes between patients who underwent laparoscopic cholecystectomy within 3 days (early phase group) and 4-7 days after symptom onset (late phase group).
  
  
  RESULTS
  There were 193 patients in the early phase group and 40 patients in the late-phase group. Performing laparoscopic cholecystectomy in the late phase did not influence operation time, postoperative complications, or postoperative hospital stay. The rate of conversion to open surgery and blood loss were slightly higher in the late-phase group (8 % and 140 ml) compared with the early phase group (3 % and 69 ml) but were still acceptable.
  
  
  CONCLUSIONS
  Late phase urgent laparoscopic cholecystectomy for acute cholecystitis was feasible and safe.
authors.affiliation: Department of Surgery, Toyonaka Municipal Hospital, 4-14-1 Shibaharacho, Toyonaka, Osaka, 560-8565, Japan.
authors.forename: Go
authors.initials: G
authors.lastname: Shinke
authors.affiliation: Department of Surgery, Toyonaka Municipal Hospital, 4-14-1 Shibaharacho, Toyonaka, Osaka, 560-8565, Japan. t-noda2000@umin.ac.jp.
authors.forename: Takehiro
authors.initials: T
authors.lastname: Noda
authors.affiliation: Department of Surgery, Toyonaka Municipal Hospital, 4-14-1 Shibaharacho, Toyonaka, Osaka, 560-8565, Japan.
authors.forename: Hisanori
authors.initials: H
authors.lastname: Hatano
authors.affiliation: Department of Surgery, Osaka Rosai Hospital, Sakai, Osaka, Japan.
authors.forename: Junzo
authors.initials: J
authors.lastname: Shimizu
authors.affiliation: Department of Surgery, Toyonaka Municipal Hospital, 4-14-1 Shibaharacho, Toyonaka, Osaka, 560-8565, Japan.
authors.forename: Masashi
authors.initials: M
authors.lastname: Hirota
authors.affiliation: Department of Surgery, Toyonaka Municipal Hospital, 4-14-1 Shibaharacho, Toyonaka, Osaka, 560-8565, Japan.
authors.forename: Akihiro
authors.initials: A
authors.lastname: Takata
authors.affiliation: Department of Surgery, Toyonaka Municipal Hospital, 4-14-1 Shibaharacho, Toyonaka, Osaka, 560-8565, Japan.
authors.forename: Kazuteru
authors.initials: K
authors.lastname: Oshima
authors.affiliation: Department of Surgery, Toyonaka Municipal Hospital, 4-14-1 Shibaharacho, Toyonaka, Osaka, 560-8565, Japan.
authors.forename: Tsukasa
authors.initials: T
authors.lastname: Tanida
authors.affiliation: Department of Surgery, Toyonaka Municipal Hospital, 4-14-1 Shibaharacho, Toyonaka, Osaka, 560-8565, Japan.
authors.forename: Takamichi
authors.initials: T
authors.lastname: Komori
authors.affiliation: Department of Surgery, Toyonaka Municipal Hospital, 4-14-1 Shibaharacho, Toyonaka, Osaka, 560-8565, Japan.
authors.forename: Shunji
authors.initials: S
authors.lastname: Morita
authors.affiliation: Department of Surgery, Toyonaka Municipal Hospital, 4-14-1 Shibaharacho, Toyonaka, Osaka, 560-8565, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Imamura
authors.affiliation: Department of Surgery, Toyonaka Municipal Hospital, 4-14-1 Shibaharacho, Toyonaka, Osaka, 560-8565, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Iwazawa
authors.affiliation: Department of Surgery, Toyonaka Municipal Hospital, 4-14-1 Shibaharacho, Toyonaka, Osaka, 560-8565, Japan.
authors.forename: Kenzo
authors.initials: K
authors.lastname: Akagi
authors.affiliation: Department of Surgery, Toyonaka Municipal Hospital, 4-14-1 Shibaharacho, Toyonaka, Osaka, 560-8565, Japan.
authors.forename: Keizo
authors.initials: K
authors.lastname: Dono
mesh_terms: D017081:Cholecystectomy, Laparoscopic / Q000379:methods*; D041881:Cholecystitis, Acute / Q000601:surgery*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007902:Length of Stay / Q000639:trends; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D011184:Postoperative Period
keywords: Acute cholecystitis; Blood loss; Emergency operation; Laparoscopic cholecystectomy; Late phase