Iraqi Journal of Medical Sciences

Vol. 12 Issue 1 January - March / 2014
Published on website | Date : 2016-03-27 13:08:21


Osama M. Alabid, Hassan A. Hassan


Background:Despite the well-accepted success of laparoscopic cholecystectomy (LC) in the elective treatment of symptomatic gallstone, the safety and the efficacy of this technique has been subjected to some debate in the setting of acute cholecystitis (AC).
Objective:To evaluate our institution’s experience with early LC and to evaluate the safety and effectiveness of LC in the treatment of AC.
Methods: Eighty nine patients were diagnosed as having AC based on the clinical, laboratory and ultrasound findings; 80 patients were divided randomly into two equal groups.
Group 1 included 40 patients who had early LC for AC within one week from onset of the symptoms and group 2 included 40 patients who had late LC around 6 weeks from onset of symptoms as interval LC after conservative treatment.
Results:No significant difference in the conversion rate (in early group 8 patients (20%) versus delayed group 6 patients (15%). Complication rate was insignificant (in early group 4 patients (10%) versus delayed group 3 patients (7.5%). The delayed group had a significantly shorter operative time (early group = 128±53.5 min versus delayed group = 107±50.1 min) and significantly shorter postoperative stay (early = 2.4±3.2 days versus delay = 1.4±1.4 days). The early group had a significantly shorter total hospital stay (early = 5.5±3.1 days versus delay = 8.5±4.5 days). The male gender had a significant higher conversion rate in both groups.
Conclusion:Early LC can be performed safely in most patients with AC and it is considered as effective treatment, allows significantly shorter total hospital stay with no significant differences in conversion rate or complications compared with delayed LC, in the hands of a safe and well trained surgeon.
Keywords:Early laparoscopic cholecystectomy, acute cholecystitis.