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Timing of Cholecystectomy in Acute Cholecystitis
Arasi Thangavelu1, Steven Rosenbaum2, Devi Thangavelu3
1Department of Emergency Medicine, Archbold Medical Center, Thomasville, Georgia; Florida State University, College of Medicine, Tallahassee, Florida.
Background:
Cholecystitis is an inflammation of the gallbladder that most commonly occurs as a result of obstruction of the cystic duct by gallstones. The current standard of treatment for acute cholecystitis is cholecystectomy.
Objective:
Our goal was to discuss the benefits of and compare early laparoscopic cholecystectomy and delayed laparoscopic cholecystectomy in the treatment of acute cholecystitis.
Materials And Methods:
A Medline literature search was performed dating from January 1982 to July 2015. We limited the search to human studies written in English and using the keywords "Acute Cholecystitis," early vs. delayed laparoscopic cholecystectomy, surgical management, and surgical complications.
Results:
There were 225 articles reviewed, of which 25 met criteria for selection. Our recommendations are based on these 25 articles.
Conclusion:
Early laparoscopic cholecystectomy is preferred over delayed, due to overall better quality of life, lower morbidity rates, and lower hospital cost. Ultimately, management of acute cholecystitis by emergency physicians should be made based on patient's clinical status and available resources in their particular hospital.
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