Outcomes after early vs interval cholecystectomy for perforated Cholecystitis:A multicenter cohort study

Area of Science:

• Gastroenterology
• Surgical Outcomes
• Gallbladder Diseases

Background:

• Gallbladder perforation is a rare but serious condition with significant morbidity.
• The optimal timing for cholecystectomy in perforated cholecystitis remains a subject of debate.
• Early intervention versus delayed surgery impacts patient outcomes.

Purpose of the Study:

• To compare the outcomes of early (same-admission) versus interval (delayed) cholecystectomy in patients with perforated cholecystitis.
• To determine if early cholecystectomy is associated with improved safety and reduced complications.
• To analyze operative details and short-term outcomes between the two surgical timing groups.

Main Methods:

• A multi-institutional retrospective review of 230 patients who underwent cholecystectomy for perforated cholecystitis between 2014 and 2023.
• Comparison of presenting characteristics, operative details, and short-term outcomes between early cholecystectomy (EC) and interval cholecystectomy (IC) groups.
• Statistical analysis to identify significant differences in outcomes, including surgical approach, infections, and hospital stay.

Main Results:

• 87.4% of patients underwent early cholecystectomy (EC), while 12.6% had interval cholecystectomy (IC).
• Patients undergoing IC were more likely to require open surgery (55.2% vs 35.3%) and develop surgical site infections (17.2% vs 4.0%).
• Interval cholecystectomy was associated with a longer total hospital stay (median 8 days vs 5 days).

Conclusions:

• Early cholecystectomy for perforated cholecystitis is a safe and potentially preferable approach.
• EC is associated with a reduced likelihood of open surgery and surgical site infections compared to IC.
• Choosing early cholecystectomy may lead to shorter overall hospitalizations for patients with perforated cholecystitis.