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Laparoscopic Common Bile Duct Exploration in Patients with a Previous History of Biliary Tract Surgery

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

Salah Mansor^1,2, Amine Zaidi³, Mohammad Habibullah³

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

Asian Journal of Endoscopic Surgery

|May 6, 2025

Summary

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.

Keywords:

acute cholecystitis delayed cholecystectomy early cholecystectomy laparoscopic cholecystectomy

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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.