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Timing of laparoscopic cholecystectomy for acute cholecystitis: a prospective non randomized study
George Tzovaras1, Dimitris Zacharoulis, Paraskevi Liakou
1Department of Surgery, University of Thessaly School of Medicine, University Hospital of Larissa, 19 Agorogianni A. Street, Larissa 41335, Greece. gtzovaras@hotmail.com
Aim:
To study the timing of laparoscopic cholecystectomy for patients with acute cholecystitis.
Methods:
Between January 2002 and December 2005, all American Society of Anesthesiologists classification (ASA) I, II and III patients with acute cholecystitis were treated laparoscopically during the urgent (index) admission. The patients were divided into three groups according to the timing of surgery: (1) within the first 3 d, (2) between 4 and 7 d and (3) beyond 7 d from the onset of symptoms. The impact of timing on the conversion rate, morbidity and postoperative hospital stay was studied.
Results:
One hundred and twenty-nine patients underwent laparoscopic cholecystectomy for acute cholecystitis during the index admission. Thirty six were assigned to group 1, 58 to group 2, and 35 to group 3. The conversion rate and morbidity for the whole cohort of patients were 4.6% and 10.8%, respectively. There was no significant difference in the conversion rate, morbidity and postoperative hospital stay between the three groups.
Conclusion:
Laparoscopic cholecystectomy for acute cholecystitis during the index admission is safe, regardless of the time elapsed from the onset of symptoms. This policy can result in an overall shorter hospitalization.
