Operative timing of laparoscopic cholecystectomy for acute cholecystitis in a Japanese institute

• Published in: Journal of the Society of Laparoendoscopic Surgeons Vol. 16; no. 1; pp. 65 - 70
• Main Authors: Ohta, Masayuki, Iwashita, Yukio, Yada, Kazuhiro, Ogawa, Tadashi, Kai, Seiichiro, Ishio, Tetsuya, Shibata, Kohei, Matsumoto, Toshifumi, Bandoh, Toshio, Kitano, Seigo
• Format: Journal Article
• Language: English
• Published: United States Society of Laparoendoscopic Surgeons 01.01.2012
• Subjects: Adult; Cholecystectomy, Laparoscopic; Cholecystitis, Acute - diagnosis; Cholecystitis, Acute - epidemiology; Cholecystitis, Acute - surgery; Comorbidity; Female; Humans; Japan; Length of Stay; Male; Middle Aged; Retrospective Studies; Scientific Papers; Japan
• ISSN: 1086-8089; 1938-3797
• DOI: 10.4293/108680812x13291597716023

In patients with acute cholecystitis who cannot undergo early laparoscopic cholecystectomy (within 72 hours), 6 weeks to 12 weeks after onset is widely considered the optimal timing for delayed laparoscopic cholecystectomy. However, there has been no clear consensus about it. We aimed to determine optimal timing for delayed laparoscopic cholecystectomy for acute cholecystitis. Medical records of 100 patients who underwent standard laparoscopic cholecystectomy were reviewed retrospectively. Patients were divided into group 1, patients undergoing laparoscopic cholecystectomy within 72 hours of onset; group 2, between 4 days to 14 days; group 3, between 3 weeks to 6 weeks; group 4, >6 weeks. No significant differences existed between groups in conversion rate to open surgery, operation time, blood loss, or postoperative morbidity, and hospital stay. However, total hospital stay in groups 1 and 2 was significantly shorter than that in groups 3 and 4 (P<.01). In addition, the total hospital stay in group 3 was also significantly shorter than that in group 4 (P<.01). Best timing of laparoscopic cholecystectomy for acute cholecystitis may be within 72 hours, and the delayed timing of laparoscopic cholecystectomy in patients who cannot undergo early laparoscopic cholecystectomy is probably as soon as possible after they can tolerate laparoscopic cholecystectomy.