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Urgent versus interval laparoscopic cholecystectomy for acute cholecystitis: a comparative study
Author(s) -
Bhattacharya Debashis,
Senapati Polybody S. P.,
Hurle Rhidian,
Ammori Basil J.
Publication year - 2002
Publication title -
journal of hepato‐biliary‐pancreatic surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.63
H-Index - 60
eISSN - 1868-6982
pISSN - 0944-1166
DOI - 10.1007/s005340200070
Subject(s) - acute cholecystitis , laparoscopic cholecystectomy , medicine , general surgery , cholecystectomy , interval (graph theory) , cholecystitis , gallbladder , surgery , mathematics , combinatorics
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 96h 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 96h 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.