Admission after the gold interval in acute calculous cholecystitis: Should we really cool it off?

The aim of this study was to compare early and delayed cholecystectomy for the treatment of acute calculous cholecystitis (ACC).

The medical records of patients who were diagnosed to have ACC by combined clinical and radiological examination were evaluated retrospectively. The patients were divided into two non-randomized groups according to the duration between the onset of symptoms and cholecystectomy. Group 1 included the patients who underwent cholecystectomy within the first 72 h after the onset of symptoms and Group 2 those who underwent beyond the 72nd hour after the onset of symptoms.

We reviewed records for 203 patients. There were 109 patients in Group 1 and 74 patients in Group 2. Access-related complications occurred in four patients. One patient in Group 1 and two patients in Group 2 had trocar site bleeding. In one patient in Group 1, liver trauma occurred. Two patients had bile duct injury in Group 1 as Type D injury according to the Strasberg classification in one patient and E2 injury in other.

Early cholecystectomy in acute cholecystitis with biliary stones could be performed regardless of time with similar complication, mortality and conversion rates.