Early Versus Delayed Laparoscopic Cholecystectomy for Treatment of Acute Cholecystitis
Open Access
- 1 January 1996
- journal article
- research article
- Published by Ovid Technologies (Wolters Kluwer Health) in Annals of Surgery
- Vol. 223 (1), 37-42
- https://doi.org/10.1097/00000658-199601000-00006
Abstract
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 va. 12.4 days; p < 0.001). Conclusions: Early laparoscopic cholecystectomy for the treatment of acute cholecystitis has no adverse effect on complication and conversion rates. Although it is technically demanding and time consuming, this procedure provides the economic advantage of a markedly reduced total hospital stay.published_or_final_versioKeywords
This publication has 20 references indexed in Scilit:
- Laparoscopic cholecystectomy for acute cholecystitisBritish Journal of Surgery, 1994
- Laparoscopic Cholecystectomy for Acute Inflammation of the GallbladderAnnals of Surgery, 1993
- Cost-effectiveness of laparoscopic cholecystectomy versus open cholecystectomyThe American Journal of Surgery, 1993
- National Institutes of Health Consensus Development Conference Statement on Gallstones and Laparoscopic CholecystectomyThe American Journal of Surgery, 1993
- Factors Associated with Successful Laparoscopic Cholecystectomy for Acute CholecystitisAnnals of Surgery, 1993
- Laparoscopic cholecystectomy as a safe and effective treatment for severe acute cholecystitis.BMJ, 1992
- Laparoscopie Cholecystectomy Treatment of Choice for Symptomatic CholelithiasisAnnals of Surgery, 1991
- Early or delayed cholecystectomy in acute cholecystitis? A clinical trialBritish Journal of Surgery, 1983
- Early versus delayed cholecystectomy: The effect of a change in managementBritish Journal of Surgery, 1981
- Early Cholecystectomy for Acute CholecystitisAnnals of Surgery, 1980