Early (<24 h) or Delayed Cholecystectomy for Acute Cholecystitis?

2016 ◽  
pp. 201-208
Author(s):  
Stephan G. Wyers
Keyword(s):  
Acute Cholecystitis ◽  
Delayed Cholecystectomy

Time to abandon the old dictum of delayed laparoscopic cholecystectomy after acute cholecystitis has settled in Caribbean practice

2021 ◽  
pp. 004947552110100
Author(s):  
Shamir O Cawich ◽  
Avidesh H Mahabir ◽  
Sahle Griffith ◽  
Patrick FaSiOen ◽  
Vijay Naraynsingh
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Acute Cholecystitis ◽  
Gold Standard ◽  
Standard Treatment ◽  
Gallstone Disease ◽  
Acute Attack ◽  
Early Laparoscopic Cholecystectomy ◽  
Delayed Surgery ◽  
Delayed Cholecystectomy ◽  
Delayed Laparoscopic Cholecystectomy

Although laparoscopic cholecystectomy is the gold standard treatment for acute cholecystitis, many Caribbean surgeons are reluctant to operate during the acute attack. We collected data for all consecutive patients who underwent laparoscopic cholecystectomy for acute cholecystitis from January 1 to 31 December 2018. Delayed cholecystectomy was done >6 weeks after acute cholecystitis settled. We compared data between early and delayed groups. Delayed laparoscopic cholecystectomy was performed in 54 patients, and 42 had early laparoscopic cholecystectomy. Delayed surgery resulted in significantly more complications requiring readmission (39% vs 0), longer operations (2.27 vs 0.94 h) and lengthier post-operative hospitalisation (1.84 vs 1.1 days). Caribbean hospitals should abandon the practice of delayed surgery after cholecystitis has settled. Early laparoscopic cholecystectomy would be financially advantageous for our institutions, and it would save patients recurrent attacks of gallstone disease.

scholarly journals Early versus delayed cholecystectomy in acute cholecystitis: a comparative study in a tertiary care hospital

2020 ◽  
Vol 7 (8) ◽  
pp. 2656
Author(s):  
Jamal Uddin Ahmed ◽  
Subal Rajbongshi ◽  
Najim Hiquemat
Keyword(s):  
Acute Cholecystitis ◽  
Elective Surgery ◽  
Tertiary Care ◽  
Definitive Treatment ◽  
P Value ◽  
Care Hospital ◽  
Early Cholecystectomy ◽  
Delayed Cholecystectomy ◽  
Surgery Group ◽  
Duration Of Surgery

Background: For patients with acute cholecystitis the timing of operative intervention has two broad approaches- early cholecystectomy and elective or delayed cholecystectomy. The main advantage of early cholecystectomy is that, it offers a definitive treatment during the same admission and avoids the problem of failed conservative treatment. The present study is an endeavour to discuss and to compare the outcome of management of acute cholecystitis with early and delayed cholecystectomy.Methods: 100 patients with clinical diagnosis of acute cholecystitis, admitted in the surgical wards of Gauhati Medical College and Hospital during the period of 1st July 2017 to 30th June 2018 were selected for the study. 40 patients underwent early cholecystectomy (within 7 days of onset of symptoms) and 60 patients underwent elective or late cholecystectomy (after a gap of 6-8 weeks from the acute attack).Results: In the present series the average duration of surgery was 90.37±11.96 minutes in the early group and 65.3±7.83 minutes for the elective group which is found to be statistically significant (p value<0.05). In the early surgery group 8.33% required conversion to open surgery. In the elective surgery group 3.63% required conversion. Wound infection, biliary leakage, bile duct injury, and respiratory tract infection was found to be statistically not significant between the two groups.Conclusions: Early cholecystectomy is feasible and safe for acute cholecystitis and is better method of treatment because of its shorter hospital stay, which is a major economic benefit to both the patient and health care system.

scholarly journals LAPAROSCOPIC CHOLECYSTECTOMY;

2013 ◽  
Vol 20 (02) ◽  
pp. 313-318
Author(s):  
MOHAMMAD ADNAN NAZEER ◽  
HASAAN IMTIAZ ◽  
HARUN MAJID DAR ◽  
Zulfiqar Ali ◽  
Asma Samreen
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Acute Cholecystitis ◽  
Controlled Trial ◽  
Early Laparoscopic Cholecystectomy ◽  
Delayed Cholecystectomy ◽  
Laparoscopic Cholecystectomy Group ◽  
Delayed Laparoscopic Cholecystectomy ◽  
Delayed Group ◽  
Group 2 ◽  
Group 1

Introduction: The role of laparoscopic cholecystectomy in treatment of acute cholecystitis is still controversial. Objective:The objective of this prospective randomized controlled trial was to evaluate the outcomes of early laparoscopic cholecystectomy foracute cholecystitis and to compare the results with delayed cholecystectomy. Setting: Sheikh Zayed Hospital, Lahore. Period: 1st Feb,2012 to 31st July 2012. Materials & Methods: 60 diagnosed patients of acute cholecystitis were randomly allocated to two groups,Group 1 underwent early laparoscopic cholecystectomy (Group 1, n = 30) and Group 2 to initial conservative treatment followed bydelayed laparoscopic cholecystectomy, 6 to 12 weeks later (Group 2 , n = 30). Results: The overall complication rate was 3.3% (01) inearly group and 16.7% (05) in the delayed group. There was no common bile duct injury in both groups. The complications includedwound infection and intraperitoneal collection. Conclusions: According to the results our study we concluded that early laparoscopiccholecystectomy can safely be carried out for acute cholecystitis as the complications for early laparoscopic cholecystectomy are lessas compared to delayed laparoscopic cholecystectomy. Early laparoscopic cholecystectomy has also an edge over delayed because ofsingle hospital stay.

Early Versus Delayed Cholecystectomy for Acute Cholecystitis

2017 ◽  
Vol 265 (4) ◽  
pp. e53-e54 ◽  
Author(s):  
Francesco Guerra ◽  
Luca Moraldi ◽  
Lucia Barni ◽  
Stefano Amore Bonapasta
Keyword(s):  
Acute Cholecystitis ◽  
Delayed Cholecystectomy

Management of Acute Cholecystitis: Prevalence of Percutaneous Cholecystostomy and Delayed Cholecystectomy in the Elderly

2013 ◽  
Vol 18 (2) ◽  
pp. 328-333 ◽  
Author(s):  
John D. Cull ◽  
Jose M. Velasco ◽  
Alexander Czubak ◽  
Dahlia Rice ◽  
Eric C. Brown
Keyword(s):  
Acute Cholecystitis ◽  
The Elderly ◽  
Percutaneous Cholecystostomy ◽  
Delayed Cholecystectomy

scholarly journals Subsequent Cholecystectomy Is The Most Important Factor for Recurrent Biliary Event-Free Survival in High-Risk Acute Cholecystitis Patients after Gallbladder Drainage

2020 ◽  
Author(s):  
Chi-Chih Wang ◽  
Ming-Chang Tsai ◽  
Yen-Pin Huang ◽  
Wen-Hsin Huang ◽  
Tsung-Yu Tsai ◽  
...  
Keyword(s):  
High Risk ◽  
Acute Cholecystitis ◽  
Index Admission ◽  
University Hospital ◽  
Event Free Survival ◽  
Free Survival ◽  
Gallbladder Drainage ◽  
Delayed Cholecystectomy ◽  
Percutaneous Transhepatic Gallbladder Drainage ◽  
Related Mortality

Abstract Background and Aims: Cholelithiasis is a disease with increasing prevalence over the decades. Gallbladder drainage is an alternative choice in critically ill patients who cannot tolerate early surgery for acute cholecystitis. In previous data, early or delayed cholecystectomy leads to less recurrent biliary events comparing to using a wait-and-see strategy. We wondered if the subsequent cholecystectomy strategy is the most important factor to improve recurrent biliary event-free survival after gallbladder drainage. The present study aimed to explore the most important factor to improve the clinical outcome after percutaneous transhepatic gallbladder drainage.Methods: We studied 211 adult acute cholecystitis patients who received percutaneous transhepatic gallbladder drainage during index admission between July 2017 and December 2018 in Chung Shan Medical University Hospital and Changhua Christian Hospital. Patients who died during the index admission or lost follow-up within 30 days were excluded. We further divided these patients into those who received subsequent cholecystectomy within 2 months and those who received no cholecystectomy within 2 months. Recurrent biliary events, mortality and biliary event-related mortality were compared. Multivariate analysis was applied to find the most important factors of recurrent biliary event-free survival.Results: There were 8 cases (13.6%) in the subsequent cholecystectomy group that experienced recurrent biliary events, while 39 cases (32.2%) experienced recurrent biliary events in the no cholecystectomy within 2 months group. The proportion and average recurrent biliary events per person were all significantly lower in the subsequent cholecystectomy group. The recurrent biliary event-related mortality difference is insignificant. The most decisive factor to determine recurrent biliary event-free survival is whether a subsequent cholecystectomy performed or not (HR:0.485, 95% CI: 0.250-0.941, p=0.032).Conclusion: Subsequent cholecystectomy can decrease further recurrent biliary events and improve recurrent biliary event-free survival in high risk patients with acute cholecystitis that accepted percutaneous transhepatic gallbladder drainage initially.

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