Urgent versus interval laparoscopic cholecystectomy for acute cholecystitis: a comparative study.

BACKGROUND/PURPOSE: The surgical management of patients presenting with acute cholecystitis remains controversial. The aim of this study was to evaluate the safety and feasibility of urgent laparoscopic cholecystectomy (LC) during the "index" (acute) admission with acute cholecystitis, and to compare that with a policy of interval LC.

METHODS

Between October 2000 and October 2001, 50 patients who had suffered with acute cholecystitis underwent LC. Thirty-three patients underwent surgery during the index admission (group I), of whom 11 patients had surgery within 96 h of admission. Seventeen patients were referred by colleagues to outpatients for, and underwent, an interval LC (group II).

RESULTS

All operations were completed laparoscopically. There was no difference between the groups in the operating time (median [interquartile range]: 78 [61-124] versus 93 [53-128] min) or postoperative hospital stay (median, 1 day). The delay in performing an urgent LC beyond 96 h did not affect the operating time or postoperative stay but significantly increased the total hospital stay (median [interquartile range]: 5 (5-8) versus 13 [8-17] days; P = 0.001).

CONCLUSIONS

Laparoscopic cholecystectomy during the index admission with acute cholecystitis can be performed safely and successfully. Earlier surgery has a beneficial impact for patients and the National Health Service.