Abstract

Introduction: Elective laparoscopic cholecystectomy has become the gold standard for
treatment of symptomatic gallstones. However, in the early days, acute cholecystitis was
a contraindication of laparoscopic cholecystectomy. The aim of this study was to
compare the intra-operative and postoperative outcomes of early versus delayed
laparoscopic cholecystectomy for acute cholecystitis.
Materials and Methods: A randomized clinical study was conducted by the Department
of General Surgery, Narayan Medial College & Hospital, Jamuhar, Bihar from May
2020 to February 2021. A total of 100 patients whose physical, laboratory, and
ultrasound findings suggested acute cholecystitis, and who were operated on by
laparoscopy, was included in the study. Acute cholecystitis diagnosis was based on a
combination of clinical and radiologic criteria. . Each patient gave written informed
consent before participation in the study. Approval for this study was obtained from the
Institutional Ethics Committee. The statistical analyses were performed using
commercially available software (Statistical Package for Social Sciences version 16.0,
SPSS Inc, Chicago, Illinois).
Results: The study groups, which underwent early or delayed laparoscopic
cholecystectomy, had 50 patients each. Both groups revealed similar findings on
physical examination: all patients had tenderness and defense in the abdominal area.
On ultrasonography, calculi in the gallbladder were detected in all of the patients, and
thickness of the anterior gallbladder wall was increased in majority of the patients of
both the groups. There was no significant difference between the early and the delayed
laparoscopic cholecystectomy groups in terms of operation time and rates for
conversion to open cholecystectomy.
Conclusion: Early laparoscopic cholecystectomy should be preferred by surgeons for
treatment of acute cholecystitis with the advantage of shorter hospital stay and early
ambulation.