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Acute cholecystitis treated by early and delayed surgery. A controlled clinical trial
Scandinavian Journal of Gastroenterology
|January 1, 1978
Summary
Early surgery for acute cholecystitis (AC) is recommended. This approach avoids complications from delayed treatment and offers easier operations without increased mortality risk compared to delayed surgery.
Area of Science:
- Gastroenterology
- Surgical Innovation
- Clinical Trials
Background:
- Acute cholecystitis (AC) presents diagnostic and therapeutic challenges.
- Management strategies for AC include early surgery and delayed surgery.
- Patient selection criteria included elevated serum bilirubin and/or amylase.
Purpose of the Study:
- To compare the outcomes of early surgery (ES) versus delayed surgery (DS) for acute cholecystitis.
- To evaluate complications, mortality, and operative difficulty between ES and DS groups.
- To determine the optimal timing for surgical intervention in AC.
Main Methods:
- A randomized controlled trial involving 100 patients with AC.
- Patients were divided into two groups: early surgery (within 7 days) and delayed surgery (2-3 months).
- Outcomes assessed included mortality, complications (peritonitis, jaundice, wound infection, retained stones), and operative time.
Main Results:
- No mortality in the early surgery group versus 2 deaths in the delayed surgery group.
- Delayed surgery group had a 24% recurrence rate of AC and higher rates of wound infection and retained stones.
- Operative time was significantly shorter in the early surgery group (76.7 min) compared to the delayed surgery group (98.0 min).
Conclusions:
- Early surgery for acute cholecystitis is recommended.
- ES avoids complications associated with failed medical treatment and delayed intervention.
- ES offers a safer and more efficient treatment option for AC without increasing overall risk.