The Outcome of Laparoscopic Cholecystectomy within the First 72 Hours of Acute Cholecystitis versus Laparoscopic Cholecystectomy Performed after 72 Hours Till the End of the First Week

Abstract Background: Cholecystectomy for acute calcular chole-cystitis is the most frequent surgical procedure performed by general surgeons comprising approximately 500000 operations annually in USA. Laparoscopic cholecystectomy became the gold standard treatment for acute non-complicated calcular cholecystitis but the appropriate time remains controversial. Aim of Study: The aim of this study was to compare between laparoscopic cholecystectomy within the first 72 hours of clinical presentation (Group A) and laparoscopic cholecystectomy after 72 hours till the end of the first week (Group B) in acute calcular cholecystitis regarding operative and postoperative outcome. Patients and Methods: This study was a prospective comparative study including 30 patients who had been diag-nosed with acute calcular cholecystitis in the period between November 2020 and November 2021. The cases were collected from emergency room and outpatient clinics in Ain Shams University hospitals and policehospitals in Egypt. Results: Of the 30 patients, 16 were operated upon within 72 hours of presentation while 14 were operated beyond 72 hours till the end of the firs tweek. The mean operative time in the early group was significantly higher than delayed the group (116.13 versus 86.67min, p=0.003). There was no significant difference regarding the intraoperative complica-tions or conversion rate to open cholecystectomy in both groups. Regarding the postoperative data there was no signif-icant difference according to the length of postoperative hospital stay and postoperative complications. Conclusion: Early laparoscopic cholecystectomy for acute non-complicated cholecystitis within 72 hours from onset of symptoms (although longer operative time) is a safe procedure with similar hospital stay and comparable morbidity with late laparoscopic cholecystectomy after 72 hours.