A Prospective Randomised Trial Comparing Early versus Delayed Laparoscopic Cholecystectomy in the Treatment of Acute Cholecystitis.
Abstracts
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Background: The aim of this prospective randomised study was to compare the results of early versus delayed laparoscopic cholecystectomy for treatment of acute cholecystitis. Methods: 145 patients were randomised to either early laparoscopic cholecystectomy within 48 hours after randomisation (74 patients) or initial conservative treatment followed by delayed laparoscopic cholecystectomy 6-8 weeks later (69 patients). Results: The age distribution was the same in the two groups with a mean age of 56 years (range 20 - 88). There was no significant difference in the conversion rate (early 31% vs delayed 30%), operating time or complications. There was no difference in mortality (0%) and morbidity (18%) between the two groups. Thirteen percent of the patients randomised to delayed operation, failed conservative treatment and required an emergency cholecystectomy. The early group had a total hospital stay of 5 days (range 3-63) which was significantly shorter than for the delayed group (8 days, range 4 - 50). Conclusion: Both early and delayed laparoscopic cholecystectomy is safe and effective in the treatment of acute cholecystitis. The strategy of having a delayed operation does not make the operation easier to perform, as shown by the same rate of conversion as in the early group. However, an early operation offers definite treatment during the same admission with a reduction of total hospital stay. |
