BACKGROUND/AIMS: 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. METHODOLOGY: 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. RESULTS: 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. CONCLUSION: 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.
RCT Entities:
BACKGROUND/AIMS: 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. METHODOLOGY: 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. RESULTS: 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. CONCLUSION: 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.
Authors: Jarrod K H Tan; Joel C I Goh; Janice W L Lim; Iyer G Shridhar; Krishnakumar Madhavan; Alfred W C Kow Journal: J Gastrointest Surg Date: 2017-02-27 Impact factor: 3.452
Authors: Juliane Bingener; Kristine M Thomsen; Andrea McConico; Erik P Hess; Elizabeth B Habermann Journal: J Surg Res Date: 2014-06-19 Impact factor: 2.192
Authors: Marcello Di Martino; Ismael Mora-Guzmán; Víctor Vaello Jodra; Alfonso Sanjuanbenito Dehesa; Dieter Morales-García; Rubén Caiña Ruiz; Francisca García-Moreno Nisa; Fernando Mendoza-Moreno; Sara Alonso Batanero; José Edecio Quiñones Sampedro; Paola Lora Cumplido; Altea Arango Bravo; Ines Rubio-Perez; Luis Asensio-Gomez; Fernando Pardo Aranda; Sara Sentí I Farrarons; Cristina Ruiz Moreno; Clara Maria Martinez Moreno; Aingeru Sarriugarte Lasarte; Mikel Prieto Calvo; Daniel Aparicio-Sánchez; Eduardo Perea Del Pozo; Elena Martin-Perez Journal: Updates Surg Date: 2021-02