Evaluation of Early Cholecystectomy versus Delayed Cholecystectomy in the Treatment of Acute Cholecystitis.
Objective. To evaluate if early cholecystectomy (EC) is the most appropriate treatment for acute cholecystitis compared to delayed cholecystectomy (DC).Patients and Methods. A retrospective cohort study of 1043 patients was carried out, with a group of 531 EC cases and a group of 512 DC patients. The following parameters were recorded: (1) postoperative hospital morbidity, (2) hospital mortality, (3) days of hospital stay, (4) readmissions, (5) admission to the Intensive Care Unit (ICU), (6) type of surgery, (7) operating time, and (8) reoperations. In addition, we estimated the direct cost savings of implementing an EC program.Results. The overall morbidity of the EC group (29.9%) was significantly lower than the DC group (38.7%). EC demonstrated significantly better results than DC in days of hospital stay (8.9 versus 15.8 days), readmission percentage (6.8% versus 21.9%), and percentage of ICU admission (2.3% versus 7.8%), which can result in reducing the direct costs. The patients who benefited most from an EC were those with a Charlson index > 3.Conclusions. EC is safe in patients with acute cholecystitis and could lead to a reduction in the direct costs of treatment.
Department of General Surgery, Burgos University Hospital, Avenida Islas Baleares 3, 09006 Burgos, Spain.
Miguel
0000-0001-8711-0947
M
Sánchez-Carrasco
Department of General Surgery, University Hospital "Marqués de Valdecilla", Avenida Valdecilla, s/n, 39008 Santander, Spain.
Juan C
JC
Rodríguez-Sanjuán
Department of General Surgery, Burgos University Hospital, Avenida Islas Baleares 3, 09006 Burgos, Spain.
Fernando
F
Martín-Acebes
Department of Epidemiology, Preventive Medicine and Public Health, School of Medicine, University of Cantabria, Avenida Herrera Oria, s/n, 39011 Santander, Spain.
Francisco J
FJ
Llorca-Díaz
Department of General Surgery, University Hospital "Marqués de Valdecilla", Avenida Valdecilla, s/n, 39008 Santander, Spain.
Manuel
M
Gómez-Fleitas
Department of General Surgery, Burgos University Hospital, Avenida Islas Baleares 3, 09006 Burgos, Spain.
Rocío
R
Zambrano Muñoz
Department of General Surgery, Burgos University Hospital, Avenida Islas Baleares 3, 09006 Burgos, Spain.
F Javier
FJ
Sánchez-Manuel