Mansor Salah, Zaidi Amine, Habibullah Mohammad, Hourani Rizeq, Aldali Yazan, Ghali Mohamed Said, Dawdi Salahaldeen, Suliman Idress, Alobahi Mohammed, Jarboa Lutfi, Valiyapurayil Mohamed, Zarour Ahmad
Acute Care Surgery Section, Hamad General Hospital, HMC, Doha, Qatar.
General Surgery Department, Al-Jalla Teaching Hospital, Benghazi University, Benghazi, Libya.
Asian J Endosc Surg. 2025 Jan-Dec;18(1):e70052. doi: 10.1111/ases.70052.
Surgery for acute cholecystitis is time-critical; the timing of laparoscopic cholecystectomy in acute cholecystitis patients has historically been controversial because of a perceived increased risk of complications. The aim is to evaluate the impact of operative timing within 7 days of symptom onset on patient outcomes.
A retrospective cohort study of patients who underwent laparoscopic cholecystectomy within 7 days after being admitted for acute cholecystitis between January 2016 and December 2021 in the Acute Care Surgery section. The study was conducted by dividing the study population into seven groups based on the operation day for each patient to evaluate the impact of operative timing on postoperative outcomes and compare the clinical results to determine how long the operation will be safe.
Within the study period, 3299 acute cholecystitis patients underwent laparoscopic cholecystectomy. The mean age was 42.4 years, with 50.1% of them being women and 49.9% of them being men. The rate of patients older than 65 years was 6.2%. A total of 237 patients (7.18%) had complications; the conversion to open surgery occurred in 27 patients (0.8%); and the overall reoperation rate was 0.5% (17 patients).
Our study shows that delays in laparoscopic cholecystectomy scheduling for acute cholecystitis after 3 days from the onset of symptoms can lead to a longer operative duration as well as a longer hospital stay. However, it does not significantly impact overall complications and reoperation rates, allowing a feasible and safe procedure to be performed within 7 days.
急性胆囊炎手术时机至关重要；由于认为并发症风险增加，急性胆囊炎患者行腹腔镜胆囊切除术的时机一直存在争议。目的是评估症状出现后7天内手术时机对患者预后的影响。
对2016年1月至2021年12月期间在急性护理外科因急性胆囊炎入院后7天内行腹腔镜胆囊切除术的患者进行回顾性队列研究。该研究通过根据每位患者的手术日将研究人群分为七组，以评估手术时机对术后结局的影响，并比较临床结果以确定手术安全的时长。
在研究期间，3299例急性胆囊炎患者接受了腹腔镜胆囊切除术。平均年龄为42.4岁，其中女性占50.1%，男性占49.9%。65岁以上患者的比例为6.2%。共有237例患者（7.18%）出现并发症；27例患者（0.8%）转为开腹手术；总体再次手术率为0.5%（17例患者）。
我们的研究表明，急性胆囊炎症状出现3天后延迟安排腹腔镜胆囊切除术会导致手术时间延长以及住院时间延长。然而，这对总体并发症和再次手术率没有显著影响，使得在7天内可进行可行且安全的手术。
