TIMING OF MINIMAL INVASIVE GALLBLADDER SURGERY IN ACUTE CHOLECYSTITIS: EARLY OR DELAYED?

Abstract

Background: Acute cholecystitis is commonly managed through laparoscopic cholecystectomy (LC), but there remains a ongoing controversy regarding optimal timing. Current analysis compares early phase laparoscopic gallbladder removal in 4 days of initiation of symptom to interval laparoscopic Gall bladder removal approximately 6 weeks later.

Methods: The study enrolled 72 patients diagnosed with acute calculous cholecystitis were allocated into 2 batches (n= 36). Batch 1 underwent early LC, while Batch 2 received interval LC. Demographic data, clinical features, biochemical and radiological findings, laboratory and radiological findings, surgical observations were evaluated using standard statistical tools.  Outcome: Demographic parameters like age(p-0.59), sex(p-0.795), region of discomfort (p-0.56), and symptom duration (p-0.493) showed no significant difference. A notable variation was found with pericholecystic oedema (p-0.0017), gallbladder appearance(p<0.001), SGOT(p<0.001), and Alkaline Phosphatase(p<0.001). Mean operative time was slightly higher in ELC (80.6min vs. 79.7min, p-0.15), but not statistically significant. Postoperative complications and hospital stay were comparable (p=0.5 and p=0.49).

Conclusion: Findings support early gallbladder surgery via laparoscopy as reliable and efficient method for managing acute cholecystitis, showing comparable outcomes to interval surgery despite increased intraoperative challenges. ELC can reduce the need for readmission and potentially lower overall healthcare burden. Larger studies are warranted for guideline development.