Extending the optimal timing for early laparoscopic cholecystectomy among patients presenting with acute calculous cholecystitis

Korayem, Islam M.; Bessa, Samer S.; El-Sayes, Islam

doi:10.4103/ejs.ejs_116_22

Extending the optimal timing for early laparoscopic cholecystectomy among patients presenting with acute calculous cholecystitis

Authors

Abstract

Purpose
The optimal timing of early laparoscopic cholecystectomy (ELC) from the onset of acute calculous cholecystitis (ACC) attack remains controversial. The purpose of this study was to compare the outcomes of ELC within 72 h from the onset of symptoms versus that performed after 72 h and up to 10 days from the onset of symptoms.
Patients and methods
We performed a retrospective analysis for patients who received LC for ACC between August 1, 2018, and December 31, 2021. We compared patients who received very ELC within 72 h versus those who received ELC between 4 and 10 days from the onset of symptoms in terms of bailout procedure, postoperative complications, and postoperative hospital stay.
Results
We analyzed 90 patients, with 45 patients per group. There was no significant difference between ELC and very ELC groups regarding subtotal cholecystectomy (11 vs. 2.2%, =0.2), conversion to open surgery (9 vs. 2.2%, =0.36), postoperative bile leak (6.7 vs. 2.2%, =0.62), and the length of postoperative hospital stay (24 h, =0.12).
Conclusion
ELC is safe to perform for patients with ACC presenting beyond 3 days from the onset of symptoms, with no significant increased morbidity, provided that it is performed by well-experienced surgeons in well-equipped medical centers.

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