Laparoscopic cholecystectomy in acute cholecystitis : support for an early inter- val surgery
Journal | Volume 77 - 2014 |
Issue | Fasc.3 - Original articles |
Author(s) | A. Croo, E. De Wolf, K. Boterbergh, A. Vanlander, H. Peeters, R.I. Troisi, F. Berrevoet |
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(1) Department of General and Hepatobiliary Surgery, Liver Transplantation Service, (2) Department of Gastroenterology, Ghent University Hospital Medical School, Belgium. |
Background and study aims : Although laparoscopic cholecystec- tomy is advocated for acute cholecystitis, debate still exists about its optimal timing. This retrospective study compares the outcome of laparoscopic cholecystectomy within versus later than 5 days of onset of symptoms in patients with acute cholecystitis. Patients and methods : One hundred thirty six patients with acute cholecystitis grade I or II were included in the study and divided in two groups. Group 1 received surgery within 5 days of symptoms and group 2 received conservative therapy and delayed surgery after 6 weeks. Results : Group 1 and 2 consisted of 100 and 36 patients respec- tively. Because of failure of conservative therapy 5 patients of group 2 had surgery before 6 weeks. The remaining 31 patients underwent surgery after 6 weeks. Preoperative ERCP was indi- cated in 2 and 11 patients in groups 1 and 2 respectively (p < 0.001). The median total hospital stay was 3.0 days for group 1 and 11.0 days for group 2 (p < 0.001). In terms of operation time, con- version rates, intraoperative cholangiography, postoperative ERCP, morbidity or mortality both groups were comparable (p > 0.05). Conclusion : Laparoscopic cholecystectomy can be performed safely within 5 days after the onset of symptoms in patients with acute cholecystitis. Because of shortened total hospital stay and risk of failure of conservative therapy, early laparoscopic cholecystec- tomy should be favored. (Acta gastroenterol. belg., 2014, 77, 306- 311). |
© Acta Gastro-Enterologica Belgica. PMID 25509201 |