Early versus delayed laparoscopic cholecystectomy in treatment of acute cholecystitis

• Published in: Bratislavské lékarské listy Vol. 117; no. 6; pp. 328 - 331
• Main Authors: Rajcok, M, Bak, V, Danihel, L, Kukucka, M, Schnorrer, M
• Format: Journal Article
• Language: English
• Published: Slovakia 2016
• Subjects: Anti-Bacterial Agents - therapeutic use; Cholecystectomy, Laparoscopic - methods; Cholecystitis, Acute - therapy; Early Medical Intervention; Female; Hospitals, University; Humans; Length of Stay; Male; Middle Aged; Postoperative Period; Prospective Studies; Time Factors; Treatment Outcome; acute cholecystitis; early laparoscopic cholecystectomy; delayed laparoscopic cholecystectomy; prospective randomized trial
• ISSN: 0006-9248
• DOI: 10.4149/BLL_2016_065

Acute cholecystitis is one of the most frequent diseases occurring in the developed countries of the world. Since the advent of laparoscopic cholecystectomy there has been a lack of agreement regarding the timing of the operation in the treatment of acute cholecystitis. From September 2012 to January 2015 we carried out a prospective randomized trial at the IIIrd Surgical Department of University Hospital Milosrdní bratia in Bratislava. The aim of the trial was to compare the two basic approaches of the treatment of acute cholecystitis. During our trial, 62 patients with acute cholecystitis were admitted to the surgery department and 31 patients were treated with an early laparoscopic cholecystectomy within 72 hours after the appearance of the symptoms. Other 31 patients were primarily treated with antibiotics and subsequently underwent a delayed cholecystectomy after 6-8 weeks. Our results suggest several advantages of the early laparoscopic cholecystectomy such as shorter operation time, lower conversion rate, shorter length of hospital stay, shorter postoperative convalescence and lower cost of hospitalization. According to these results we believe that immediate laparoscopic cholecystectomy (within 24 hours from the patient's admission to hospital) should become a preferred method of treatment of the patients with acute cholecystitis (Tab. 1, Fig. 2, Ref. 17).