Optimal timing of laparoscopic cholecystectomy in treatment of acute cholecystitis

Česká verzia

Authors: M. Rajčok; Ľudovít Danihel; V. Bak; M. Oravský; M. Schnorrer
Authors place of work: III. chirurgická klinika UNsP Milosrdní bratia v Bratislave prednosta: doc. MUDr. M. Schnorrer, CSc.
Published in the journal: Rozhl. Chir., 2016, roč. 95, č. 3, s. 113-116.
Category: Original articles

Summary

Introduction:
Acute cholecystitis is one of the most frequent diseases occurring in developed countries of the world. Laparoscopic cholecystectomy is a treatment option for acute cholecystitis. Since the advent of laparoscopic cholecystectomy there has been a lack of agreement regarding the timing of the operation in the treatment of acute cholecystitis.

Method:
From September 2012 to August 2015 we carried out a prospective randomized trial at the IIIrd Surgical Department of University Hospital Milosrdní bratia in Bratislava. We compared two basic approaches to the treatment of acute cholecystitis. During the trial, 64 patients with acute cholecystitis were admitted to the surgery department. 32 patients were treated with early laparoscopic cholecystectomy within 72 hours from the appearance of the symptoms. The other 32 patients were primarily treated with antibiotics and subsequently underwent delayed cholecystectomy after 6−8 weeks.

Results:
Our results suggest several advantages of early laparoscopic cholecystectomy such as shorter operation time, lower conversion rate, shorter length of hospital stay, shorter postoperative convalescence and lower cost of hospitalisation.

Conclusion:
Based on these results we believe that immediate laparoscopic cholecystectomy (within 24 hours from the patient’s admission to hospital) should become a preferred method of treatment of patients with acute cholecystitis.

Key words:
acute cholecystectomy − early and delayed laparoscopic cholecystectomy − prospective randomized trial

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