Early Versus Delayed Laparoscopic Cholecystectomy in Acute Cholecystits

Background: Acute cholecystitis is a significant healthcare burden in Pakistan. Laparoscopic cholecystectomy has become the treatment of choice for chronic cholecystitis. Acute cholecystitis was initially considered a relative contraindication for laparoscopic cholecystectomy but subsequent reports have documented its feasibility in acute cholecystitis as well. Our aim was to compare the outcome in patients undergoing early and delayed laparoscopic cholecystectomy in acute cholecystitis. Methods: 150 patients fulfilling the inclusion criteria were selected for study and were divided into two equal groups. Group A underwent early laparoscopic cholecystectomy and Group B underwent delayed laparoscopic cholecystectomy Laparoscopic cholecystectomy was done via the standard 3-port technique. Per-operatively, operative time and conversion rate were noted and postoperative hospital stay was noted. Results: In this study 84.67% were female patients and 15.33% were male patients. The mean operative time was calculated to be 80.88 +/- 17.57 minutes in ELC and 63.11 +/- 14.26 minutes in DLC. The rate of conversions was found to be 13.33% in ELC and 9.33 % in DLC and the mean hospital stay was 2.53 +/- 1.08 days in the ELC group and 2.43 +/- 1.02 days in the DLC group. Conclusion: Both early and delayed laparoscopic cholecystectomy is possible and safe in the treatment of acute cholecystitis. The early approach has the advantage of offering patients a definitive treatment while reducing the overall total hospital stay and avoiding the problems of failure of delayed therapy.