Outcome of early laparoscopic cholecystectomy in acute cholecystitis
Keywords:
Acute, Cholecystitis, Laparoscopic, Early, Interva;, CholecystectomyAbstract
Background: Laparoscopic cholecystectomy was introduced in mid 1980s as treatment of symptomatic gallstone disease. This study was conducted to compare the outcome of early vs interval laparoscopic cholecystectomy in acute cholecystitis. Methods: It was a randomized controlled study conducted at Department of Surgery, DHQ Teaching Hospital, DI Khan from Jan 2018 to Jan 2019. Eighty patients with diagnosis of acute calculous cholecystitis were included in the study and were divided into 2 groups of 40 each. Group-A underwent early laparoscopic cholecystectomy within 72 hours of presentation. Group-B were kept on conservative treatment, discharged after improvement, and readmitted at 6 weeks interval for laparoscopic cholecystectomy. Patients who failed to respond to conservative treatment after 48 hours were operated in the same admission but were kept in group B. Length of stay, intra-operative blood loss, complications, mean operative time, and conversion rate were documented. Results: There were 6 (15%) males and 34 (85%) females in group A, and 5 (12.5%) male and 35 (87.5%) female patients in group B. Mean operating time (79.65±8.33 vs 99.5±10.78 min, p=0.002), mean operative blood loss (52.12±9.99 vs 81.22±8.63 ml, p=0.000), and mean duration of hospital stay (3.1±0.3 vs 8.1±.8 days, p=0.000) were observed in group A and B respectively. Frequency of bile duct injury was higher in group B (0% vs 0.025%), but the difference was not significant (p=0.500). Conclusion: Early laparoscopic cholecystectomy is better regarding hospital stay, early recovery, complications, and conversion rate compared to delayed laparoscopic cholecystectomy with acute cholecystitis.
Pak J Physiol 2020;16(3):18–21
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