Introduction: Acute cholecystitis is not uncommon surgical disease. Laparoscopic cholecystectomy is the method of choice of surgical treatment. The appropriate time of laparoscopic cholecystectomy remains a debatable issue in the treatment of acute cholecystitis.
Patients and methods: A total of 50 patients presented with acute cholecystitis were divided into two groups according to time elapsed between onset of symptoms and operation. Group 1 patients underwent surgery within 72 hours of onset of symptoms. Group 2 patients underwent surgery after 72 hours of onset of symptoms till about 10 days. The overall primary outcome of laparoscopic cholecystectomy included conversion rate, complication rate, mortality rate and secondary outcomes including operative time and postoperative hospital stay.
Results: As regard to outcome only one patient in the group 1 and 3 in group 2 required conversion to open surgery because of difficulty in dissection at Calot’s triangle. Complications were recorded in 12 (24%) of the cases; 2 (9%) and 10 (36%) patients in group 1 and 2, respectively. No significant difference in morbidity detected between both groups. Both preoperative and total hospital stays were significantly shorter in group 1. No mortality recorded in both groups. Univariate logistic analysis showed that age, diabetes, and complicated acute cholecystitis were significant factors associated with a higher rate of postoperative complications. In the multivariate model, diabetes and leucocytosis ≥18x109/L were the only parameters of statistical significance in estimating the risk of complicated acute cholecystitis.
Conclusion: Although the proper time of laparoscopic cholecystectomy for acute cholecystitis doesn't seem to affect the perioperative outcomes, but delaying surgery due to any patient or physician factors will increase the preoperative and total hospital stay. So, it is ideal to operate as early as possible during the same admission.