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

Janelle Cyprich1, Isabela Sandigo-Saballos1, Angela Neville1

  • 1Division of Trauma/Acute Care Surgery/Surgical Critical Care, Harbor-UCLA Medical Center, Torrance, CA, USA.

American Journal of Surgery
|July 25, 2025
PubMed

Insights

Early cholecystectomy (EC) for gallbladder perforation is safe and associated with better outcomes. This approach leads to fewer complications and shorter hospital stays compared to interval cholecystectomy (IC).

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.
Abstract

Keywords:
Early cholecystectomyGallbladder perforationPerforated cholecystitis

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