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Early Laparoscopic Cholecystectomy for Acute Cholecystitis. When Do Risks Seem Imminent?

Salah Mansor1,2, Amine Zaidi3, Mohammad Habibullah3

  • 1Acute Care Surgery Section, Hamad General Hospital, HMC, Doha, Qatar.

Asian Journal of Endoscopic Surgery
|May 6, 2025
PubMed

Insights

Timing laparoscopic cholecystectomy for acute cholecystitis within 7 days of symptom onset is safe. While delays beyond 3 days may increase operative time and hospital stay, overall complications and reoperation rates remain unaffected.

Area of Science:

  • General Surgery
  • Gastroenterology

Background:

  • Acute cholecystitis surgery is time-critical.
  • Historically, timing of laparoscopic cholecystectomy has been debated due to perceived risks.

Purpose of the Study:

  • To evaluate the impact of operative timing within 7 days of symptom onset on patient outcomes for acute cholecystitis.

Main Methods:

  • Retrospective cohort study of 3299 patients undergoing laparoscopic cholecystectomy for acute cholecystitis.
  • Patients were grouped by operation day (within 7 days of admission) to assess outcomes.
  • Analysis focused on operative duration, complications, conversion to open surgery, and reoperation rates.

Main Results:

  • A total of 237 patients (7.18%) experienced complications.
  • Conversion to open surgery occurred in 0.8% of cases (27 patients).
  • The overall reoperation rate was 0.5% (17 patients).

Conclusions:

  • Delaying laparoscopic cholecystectomy for acute cholecystitis beyond 3 days post-symptom onset may prolong operative time and hospital stay.
  • However, delaying surgery within 7 days does not significantly increase overall complications or reoperation rates.
  • Laparoscopic cholecystectomy for acute cholecystitis is feasible and safe when performed within 7 days of symptom onset.
Abstract

Keywords:
acute cholecystitisdelayed cholecystectomyearly cholecystectomylaparoscopic cholecystectomy

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