Early versus interval laparoscopic cholecystectomy for treatment of noncomplicated acute calcular cholecystitis

Laparoscopic cholecystectomy (LC) is widely established as the standard treatment in uncomplicated acute calcular cholecystitis (ACC). Despite the relevant frequency of ACC, controversies remain regarding the timing of LC. Traditionally treatment for ACC included two stages with an initial conservat...

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Bibliographic Details
Published in:The Egyptian journal of surgery : official organ of the Egyptian Society of Surgeons = Majallat al-jirāhah al-Misrīyah 2018-10, Vol.37 (4), p.543-548
Main Authors: Hegazy, Tarek, Soliman, Salah
Format: Article
Language:English
Subjects:
Care and treatment
Cholecystectomy
Cholecystitis
Comparative analysis
Laparoscopy
Medical research
Surgery
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Summary:Laparoscopic cholecystectomy (LC) is widely established as the standard treatment in uncomplicated acute calcular cholecystitis (ACC). Despite the relevant frequency of ACC, controversies remain regarding the timing of LC. Traditionally treatment for ACC included two stages with an initial conservative management followed by an interval LC. Early LC was avoided for ACC owing to concerns about potential hazards of complications and a high conversion rate. The aim of the study is to compare between patients with uncomplicated ACC treated with early LC (within 72 h) versus interval LC (after 6 weeks of conservative treatment) regarding primary and secondary outcomes. A total of 100 patients with uncomplicated ACC are divided randomly into two groups, group A, early LC, and group B, interval LC. From this study, we conclude that there is no significant difference between both groups regarding primary and secondary outcomes. Early LC is feasible and safe, and interval LC is not associated with a lower conversion rate. In group A, there is a significantly high rate of infection, with longer hospital stay in diabetics, and in group B as well, the bile leak and rate of conversion are high, with longer hospital stay in diabetics.
ISSN:1110-1121
1687-7624
DOI:10.4103/ejs.ejs_82_18