Early laparoscopic intervention in acute cholecystitis: a hospital-based study

Background and aims: The early timing of surgery in acute cholecystitis remains undefined. Laparoscopic cholecystectomy has become the standard treatment for gall stones but is associated with an increased conversion rate in acute cholecystitis. The present study aims to assess the optimal timing of Laparoscopic cholecystectomy in acute symptomatic cholecystitis with cholelithiasis. Methods: Patients attending surgical emergency of our hospital between January 2018 to September 2019 for acute pain abdomen and diagnosed as acute cholecystitis by ultrasonography and haematological examination and who underwent laparoscopic cholecystectomy were recruited. Diagnosis, duration of symptoms, the timing of surgery, outcome, postoperation stay, complications, and conversion rates were recorded. Results: A total of 60 patients who attended the surgical emergency underwent laparoscopic cholecystectomy. The surgical procedures were performed within 72 hours in 30 cases and after 72 hours in another 30 cases. Relating to interval from onset of symptoms to surgery, conversion rates for lapchole were 6/30(20%) in < 72 hours and 9/30 (30%) in > 72 hours. Complications ranged from bleeding to bile duct injuries in 1 case. Conclusion: Operative intervention for acute cholecystitis is best achieved within 72 hours and can also be done after that period. Conversion rate increases as the timing of intervention increases.

Keywords: Laparoscopic cholecystectomy, acute cholecystitis, abdominal pain, murphy’s sign.