Early laparoscopic cholecystectomy for acute cholecystitis: should we operate beyond the first week?

BackgroundThe deadline for early laparoscopic cholecystectomy (ELC) in patients with acute calculous cholecystitis (ACC) is the subject of much debate. The aim of this study was to assess outcomes of ELC in patients with more than 7 days of symptoms.MethodsIt is a retrospective analysis of 564 patients having undergone ELC for ACC between January 2003 and June 2021. Patients were divided into two groups according to the timing between the onset of symptoms and surgery: group 1 (G1), within the first 7 days of symptoms, and group 2 (G2) after day 7 of symptoms.ResultsApart from a longer operative time (G1 80 min vs. G2 90 min; p = 0.016), there were no significant differences regarding conversion rate (G1 14.5% vs. G2 13.2%; p = 0.748), both intra- and postoperative complications, mainly bile duct injuries (G1 0.2% vs. G2 0%; p = 1) and bile leakage (G1 1.2% vs. G2 0%; p = 1) and postoperative length of stay (G1 2 days [1-3] vs. G2 2 days [1-4]; p = 0.125).ConclusionEarly laparoscopic cholecystectomy could be proposed for patients with acute calculous cholecystitis even beyond 7 days of symptoms.

Automated summary

This study aimed to evaluate the outcomes of early laparoscopic cholecystectomy (ELC) in patients with acute calculous cholecystitis (ACC) who had symptoms for more than 7 days. The results showed that there were no significant differences in conversion rate, intra- and postoperative complications, and length of stay between the two groups. Therefore, ELC could be considered as a treatment option for patients with ACC even after 7 days of symptoms.