Early versus delayed laparoscopic cholecystectomy for treatment of acute cholecystitis

Objective The current study compared the results of early versus delayed laparoscopic cholecystectomy for treatment of acute cholecystitis. Summary Background Data Although recent reports have suggested the use of laparoscopic cholecystectomy for acute cholecystitis, the complication and conversion rates remain high. No data are available on whether initial medical treatment can improve the results. Method Among 497 patients who underwent laparoscopic cholecystectomy, 52 (10.5%) had a clinical diagnosis of acute cholecystitis confirmed by ultrasonography. Twenty-seven of these patients had early surgery, that is, within 120 hours of admission, and 25 had interval cholecystectomy after initial medical treatment. Results The early group required modifications in operative technique more frequently (p < 0.001). The conversion rate (7.4%) and minor complication rate (22%) were comparable. Successful early laparoscopic cholecystectomy required a longer operative time (137.2 minutes vs. 98.0 minutes; p < 0.05) and postoperative hospital stay (4.6 days vs. 2.5 days; p < 0.005) but reduced the total hospital stay (6.4 days vs. 12.4 days; p < 0.001).