Early or delayed laparoscopic cholecystectomy in acute cholecystitis? Conclusions of a controlled trial

Laparoscopic cholecystectomy is now accepted as being safe for acute cholecystitis. However, it has not become routine, because the exact timing and approach to the surgical management remains ill defined. This study evaluated the effect of timing of LC in patients with acute cholecystitis. Group 1,...

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Published inHepato-gastroenterology Vol. 56; no. 89; p. 11
Main Authors González-Rodríguez, Francisco J, Paredes-Cotoré, Jesús P, Pontón, Cristina, Rojo, Yago, Flores, Enrique, Luis-Calo, Eva San, Barreiro-Morandeira, Francisco, Punal, José A, Fernández, Aquilino, Paulos, Ana, Santos, Fernando, Cainzos, Miguel
Format Journal Article
LanguageEnglish
Published Greece 01.01.2009
Subjects
Aged
Analysis of Variance
Cholecystectomy, Laparoscopic - methods
Cholecystitis, Acute - surgery
Female
Humans
Length of Stay - statistics & numerical data
Male
Middle Aged
Postoperative Complications - epidemiology
Spain - epidemiology
Time Factors
Treatment Outcome
Spain
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Summary:Laparoscopic cholecystectomy is now accepted as being safe for acute cholecystitis. However, it has not become routine, because the exact timing and approach to the surgical management remains ill defined. This study evaluated the effect of timing of LC in patients with acute cholecystitis. Group 1, those patients who had LC for AC within 72 hours was compared with group 2, those who had LC for AC after 72 hours. Univariate logistic regression analysis and multivariate regression analysis were used to determine if any factors had a significant association with the complications, postoperative hospital stay, and conversion index. A value of p < 0.05 was considered statistically significant. Comparing the two groups, the conversion rate to an open procedure was significantly less (7.8% versus 18.4%, P_0.02) in the early treated patients. Furthermore, postoperative hospitalization (6.5 versus 9.5 days, P 0.01), and complications (8.8% versus 17.7%, P _0.02) were significantly reduced in patients undergoing early laparoscopic cholecystectomy. There is no advantage to delaying cholecystectomy for acute cholecystitis on the basis of outcomes in complications, rate of conversion to open surgery, and mean hospital stay. Thus, early cholecystectomy should be be the preferred surgical approach for patients with acute lithiasic cholecystitis.
ISSN:0172-6390