EARLY LAPAROSCOPIC CHOLECYSTECTOMY FOR ACUTE CHOLECYSTITIS: OPTIMAL TIMING OF OPERATION AND PREDICTIVE FACTORS FOR CONVERSION

Abstract Background Acute cholecystitis (AC) is one of the important causes of abdominal pain on presentation to the emergency department. Early diagnosis and treatment of AC has a positive effect on morbidity and mortality. Laparoscopic cholecystectomy (LC) is an important approach for treating acute cholecystitis nowadays. Issued data indicated that approximately 917,000 and >50,000 LCs were annually performed to treat acute cholecystitis in the United States and England, respectively. Although LCs have been extensively performed to manage acute cholecystitis, the optimal timing of LC for this given condition is inconclusive. Aim of the work The aim of this study is to prospectively compare between early and delayed laparoscopic cholecystectomy as a management of acute calcular cholecystitis along with their operative and post-operative outcomes. Patients and methods From December 2019 to December 2020 in Ain Shams University Hospitals, a prospective randomized study was conducted over 20 patients of acute cholecystitis: 10 of them underwent laparoscopic cholecystectomy from 3 day to 7 day of symptoms of acute cholecystitis, and the other 15 after 6- 8 weeks. Operation time, intraoperative and postoperative surgical complications and duration of hospital stay were assessed and compared in the 2 groups. Results Although the operation time was longer in the group with early laparoscopic cholecystectomy, but the overall complications along with the total hospital stay were less in this group of patients. Conclusion Early timing of laparoscopic cholecystectomy in relation to the onset of gall bladder inflammation may reduce the conversion rate and the total complication rate. So, early laparoscopic cholecystectomy for patients with acute cholecystitis has both medical and socioeconomic benefits and it is the preferred approach in comparison to delayed approach.

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Assessment of the optimal timing for early laparoscopic cholecystectomy in acute cholecystitis: a prospective study of the Club Coelio

Acta Chirurgica Belgica ◽

10.1080/00015458.2018.1529344 ◽

2018 ◽

Vol 119 (5) ◽

pp. 309-315 ◽

Cited By ~ 2

Author(s):

L. Brunée ◽

P. Hauters ◽

J. Closset ◽

G. Fromont ◽

S. Puia-Negelescu ◽

...

Keyword(s):

Laparoscopic Cholecystectomy ◽

Prospective Study ◽

Acute Cholecystitis ◽

Optimal Timing ◽

Early Laparoscopic Cholecystectomy ◽

A Prospective Study

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EARLY LAPAROSCOPIC CHOLECYSTECTOMY IN ACUTE CHOLECYSTITIS AT ESI PGIMSR, BASAIDARAPUR, NEW DELHI

10.36106/ijsr/9121045 ◽

2020 ◽

pp. 21-23

Author(s):

Rakesh Kumar Thakur ◽

Tanweer Karim ◽

Debarshi Jana

Keyword(s):

Laparoscopic Cholecystectomy ◽

Acute Cholecystitis ◽

Acute Attack ◽

Optimal Timing ◽

Cost Of Treatment ◽

Analgesic Requirement ◽

Early Laparoscopic Cholecystectomy ◽

Delayed Laparoscopic Cholecystectomy ◽

Duration Of Surgery ◽

The Cost

Background: Approximately 80% of the cholecystectomies are performed laparoscopically. Traditionally, acute cholecystitis is treated conservatively followed by delayed cholecystectomy 6-8 weeks after the acute attack. Various studies have addressed the optimal timing of laparoscopic cholecystectomy (LC) in patients with acute cholecystitis. The aim of this study was to compare early and delayed laparoscopic cholecystectomy. Methods: A retrospective study was conducted in 60 patients presenting with acute cholecystitis to compare early and delayed laparoscopic cholecystectomy, focussing on intra-operative and postoperative parameters like duration of surgery, surgical difficulties and complications, analgesic requirement, duration of postoperative hospital stay and wound related complications. Results: Longer operation times were required in the early group. Postoperative pain scores and analgesic requirements were almost similar in two groups. The cost of treatment in the delayed group was significantly higher. Conclusion: Though early laparoscopic cholecystectomy required longer operative times, it resulted in reduced the cost of treatment than delayed LC.

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Predictive factors for successful early laparoscopic cholecystectomy in acute cholecystitis: A prospective study

International Journal of Surgery ◽

10.1016/j.ijsu.2010.05.014 ◽

2010 ◽

Vol 8 (8) ◽

pp. 623-627 ◽

Cited By ~ 17

Author(s):

Narinder Teckchandani ◽

Pankaj Kumar Garg ◽

Niladhar S. Hadke ◽

Sudhir Kumar Jain ◽

Ravi Kant ◽

...

Keyword(s):

Laparoscopic Cholecystectomy ◽

Prospective Study ◽

Acute Cholecystitis ◽

Predictive Factors ◽

Early Laparoscopic Cholecystectomy ◽

A Prospective Study

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

Tropical Doctor ◽

10.1177/00494755211010002 ◽

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.

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LAPAROSCOPIC CHOLECYSTECTOMY;

The Professional Medical Journal ◽

10.29309/tpmj/2013.20.02.689 ◽

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.

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Comparison of Early and Delayed Laparoscopic Cholecystectomy in Acute Cholecystitis

Annals of Punjab Medical College ◽

10.29054/apmc/2021.1099 ◽

2021 ◽

Vol 15 (1) ◽

pp. 91-94

Author(s):

Muhammad Nasir ◽

Keyword(s):

Laparoscopic Cholecystectomy ◽

Acute Cholecystitis ◽

Open Cholecystectomy ◽

Early Laparoscopic Cholecystectomy ◽

Female Patients ◽

Delayed Laparoscopic Cholecystectomy ◽

Conversion To Open Cholecystectomy ◽

Group A ◽

Male Patients ◽

Group B

Background: 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 define. Careful selection of patients, the knowledge of typical procedure-related complications, and their best treatment are the key points for a safe Laparoscopic Cholecystectomy. Objective: To compare the early and delayed Laparoscopic Cholecystectomy in the acute phase in terms of frequency of conversion to open cholecystectomy. Study Design: Randomized clinical trial. Settings: Department of Surgery, Divisional Headquarter Hospital, Faisalabad. Punjab Medical College, Faisalabad Pakistan. Duration: Study was carried out over a period of six months from June 2018 to May 2019. Methodology: A total of 152 cases (76 cases in each group) were included in this study. All patients were randomly allocated to either group i.e., group -A early Laparoscopic Cholecystectomy and group-B delayed Laparoscopic Cholecystectomy. Results: Mean age was 39.09 + 8.8 and 37.05+ 8.5 years in group- A and B, respectively. In group-A, male patients were 48 (63.2%) and female patients were 28 (36.8%). Similarly, in group-B, male patients were 41 (53.9%) and female patients were 35 (46.1%). Conversion to open cholecystectomy was required in 6 patients (7.9%) of group-A and 16 patients (21.0%) of group – B. Significant difference between two groups was observed (P= 0.021). Conclusion: Early laparoscopic cholecystectomy for acute cholecystitis is safe and feasible in terms of less frequency of conversion to open cholecystectomy.

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