Early and delayed laparoscopic cholecystectomy in patientswith acute cholecystitis

الملخص EN

Background : iaparoscopic cholecystectomy (LC) gained a wide acceptance as treatment of choice for Acute cholecystitis (AC) as early in 72 hours of admission or after interval of 8-12 weeks after the patient treated by medical treatment.

Patients and Methods : a prospective study done between lsl Jan 20071-51 Jan 2010 in the first surgical unit in Baghdad teaching hospital at (Medical city).

The study included 110 patients admitted with AC to undergo LC.

They are classified in to two groups; early group who had LC done within 72 hours of admission and delayed group that LC done after interval of 812- weeks after initial medical treatment.

The diagnosis of AC was based on clinical, laboratory, ultrasonography, operative finding, and histological examination.

Results : the early group required modifications in operative technique (decompression of gall bladder and enlarging incision of epigastria port) more frequently (p < 0.001).

The conversion rate in early group was 7.3 % vs.

in delayed group was 12% and complication rate (early 14.5 % vs.

Delayed 20 %) was comparable.

Successful early LC required a longer operative time than delayed LC (early 75(95-155) minutes vs.

delayed 55 (110-32) minutes; p < 0.001) but reduced total hospital stay (early 6 (2-'15) days vs.

delayed 11 (5-25) days ; p< 0.001).

Conclusion : early LC for treatment of AC has no adverse effect on complication and conversion rates.

Although it is technically demanding and time consuming, this procedure provides a marked reduced total hospital stay.