The clock is ticking: Early versus delayed laparoscopic cholecystectomy following percutaneous cholecystostomy

The optimal timing for laparoscopic cholecystectomy following percutaneous cholecystostomy remains a subject of considerable debate, and there is conflicting evidence regarding its impact on clinical outcomes. The aim of this retrospective study is to provide evidence-based insights to optimize the management of gallbladder diseases by comparing early versus delayed cholecystectomy after initial percutaneous drainage.

We retrospectively analyzed data from 43 patients who underwent percutaneous cholecystostomy followed by laparoscopic cholecystectomy between November 2016 and December 2022. The patients were divided into two groups: Group 1 (early cholecystectomy) underwent surgery within eight weeks of cholecystostomy, and Group 2 (delayed cholecystectomy) underwent surgery after eight weeks. We compared the demographic characteristics, comorbidities, conversion rates, and postoperative outcomes between the two groups.

No statistically significant differences were found between the two groups in regard to median age, gender distribution, prevalence of comorbidities, or rates of conversion to open surgery (p = 0.999). However, patients in the delayed cholecystectomy group (Group 2) had a higher incidence of high-grade postoperative complications according to the Clavien-Dindo classification.

While the overall complication and hospital readmission rates were similar between early and delayed cholecystectomy groups, the observed increase in high-grade complications in the delayed-surgery group underscores the necessity for individualized patient management. The clock is ticking: Optimal timing requires a tailored approach that considers patient-specific factors rather than adherence to a rigid timeframe. Larger prospective studies are important for establishing definitive guidelines. Clinicians should employ a multidisciplinary patient-centered strategy to ensure optimal patient outcomes.