Early Versus Delayed Laparoscopic Cholecystectomy for Uncomplicated Acute Cholecystitis

Abdallah M Taha; Mohamed Yousef A.; Asmaa Gaber R.

doi:doi:10.11648/j.js.s.2016040301.16

| Peer-Reviewed

Early Versus Delayed Laparoscopic Cholecystectomy for Uncomplicated Acute Cholecystitis

Abdallah M Taha, Mohamed Yousef A., Asmaa Gaber R.

Published in Journal of Surgery (Volume 4, Issue 3-1)

Received: 16 March 2016 Accepted: 17 March 2016 Published: 18 April 2016

Views: Downloads:

Download PDF

Share This Article

Twitter
Linked In
Facebook

Abstract

Introduction: Acute cholecystitis is a relatively common complication of gallstones It can lead to significant morbidity and mortality from potentially life-threatening complications such as empyema, gallbladder gangrene and gallbladder perforation It presents as a surgical emergency and usually requires hospitalization for management Laparoscopic cholecystectomy is advocated for acute cholecystitis; however, the timing of cholecystectomy and the value of the additional treatments have been a matter of controversy Aim: To compare the outcome of early versus delayed laparoscopic cholecystectomy in cases of non-complicated acute cholecystitis, as its place remains controversial in the management of acute cholecystitis due to a high reported incidence of bile leaks and conversion rate Design: Prospective interventional comparative study Methods: 120 Patients admitted to Qena and Aswan universities’ hospitals with acute cholecystitis over two years period (2013-2015) were included in this study An early laparoscopic cholecystectomy (ELC), within 7 days from onset of symptoms, for 50 patients, and delayed Laparoscopic cholecystectomy (DLC) after 6 weeks of conservative treatment for 70 patients was performed Demographic details, operative findings, conversion to open surgery, operative time, complications, timing of endoscopic retrograde cholangiopancreatography (ERCP) and hospital stay for all those patients were recorded Statistical analysis was performed by SPSS version 18 Results: There was insignificant difference in the conversion rates (2 in ELC group versus 2 DLC group, p value: 0.555), post-operative hospital stay (2 days vs 1.5days, p value: 0.375) However, operative time was significantly more in the ELC group (85 minutes versus 70 minutes, p value: 0.023) Postoperative ERCP was required in 2 patients in ELC group and one patient in DLC group Pre-operative ERCP was required in 2 patients in delayed group 40% of patients (48) had previous admissions with similar symptoms Conclusion: ELC for uncomplicated acute cholecystitis is technically demanding surgery, but it is safe and do not have increased complication rate than DLC It decreases re-admission rate and overall hospital stay.

Published in	Journal of Surgery (Volume 4, Issue 3-1) This article belongs to the Special Issue Surgical Infections and Sepsis
DOI	10.11648/j.js.s.2016040301.16
Page(s)	29-33
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2016. Published by Science Publishing Group

Keywords

Acute, Cholecystectomy, Laparoscopic

References

[1]	Hartwig W, Büchler MW.: Acute cholecystitis: early versus delayed surgery Adv Surg. 2014; 48: 155-64.
[2]	Cuschieri A Approach to the treatment of acute cholecystitis: open surgical, laparoscopic or endoscopic? Endoscopy 1993; 25: 397–8.
[3]	A. Cuschieri, F Dubois, J Mouiel et al., “The European experience with laparoscopic cholecystectomy,” American Journal of Surgery, vol 161, no 3, pp 385–387, 1991.
[4]	Berci G, Sackier JM The Los Angeles experience with laparoscopic cholecystectomy Am J Surg 1991; 161: 382–4.
[5]	Kum C, Goh P, Issac J, Tekant Y, Ngoi S Laparoscopic cholecystectomy for acute cholecystitis Br J Surg 1994; 81: 1651–4.
[6]	Lai PB, Kwong KH, Leung KL, Kwok SP, Chan AC, Chung SC et al Randomised trial of early versus delayed laparoscopic cholecystectomy for acute cholecystitis.Br J Surg 1998; 85: 764–7.
[7]	Koo K, Thirlby R Laparoscopic cholecystectomy in acute cholecystitis What is the optimal timing for operation? Arch Surg 1996; 131: 540–4.
[8]	Knight J, Mercer S, Somers S, Walters AM, Sadek SA, Toh SK Timing of urgent laparoscopic cholecystectomy does not influence conversion rate Br J Surg 2004; 91: 601–4.
[9]	Bickel A, Rappaport A, Kanievski V, Vaksman I, Haj M, Geron N et al Laparoscopic management of acute cholecystitis Prognostic factors for success Surg Endosc 1996; 10: 1045–9.
[10]	Teixeira JP, Saraiva AC, Cabral AC, Barros H, Reis JR, Teixeira A Conversion factors in laparoscopic cholecystectomy for acute cholecystitis Hepatogastroenterology 2000; 47: 626–30.
[11]	Garber S, Korman J, Cosgrove J, Cohen J Early laparoscopic cholecystectomy for acute cholecystitis Surg Endosc 1997; 11: 347–50.
[12]	Larson GM, Vitale GC, Casey J, Evans JS, Gilliam G, Heuser L et al Multi-practice analysis of laparoscopic cholecystectomy in 1983 patients Am J Surg 1992; 163: 221–6.
[13]	Chandler CF, Lane JS, Ferguson P, Thompson JE, Ashley SW Prospective evaluation of early versus delayed laparoscopic cholecystectomy for treatment of acute cholecystitis Am Surg 2000; 66: 896–900.
[14]	Kiviluoto T, Siren J, Luukkonen P, Kivilaakso E Randomised trial of laparoscopic versus open cholecystectomy for acute and gangrenous cholecystitis Lancet 1998; 351: 321–5.
[15]	González-Rodríguez FJ1, Paredes-Cotoré JP, Pontón C, Rojo Y, Flores E, Luis-Calo ES, Barreiro-Morandeira F, Punal JA, Fernández A, Paulos A, Santos F,Cainzos M.: Early or delayed laparoscopic cholecystectomy in acute cholecystitis? Conclusions of a controlled trial Hepatogastroenterology. 2009 Jan-Feb; 56(89): 11-6.
[16]	Skouras C1, Jarral O, Deshpande R, Zografos G, Habib N, Zacharakis E Is early laparoscopic cholecystectomy for acute cholecystitis preferable to delayed surgery? Best evidence topic (BET) Int J Surg. 2012; 10(5):250-8 doi: 10.1016/j.ijsu.2012.04.012 Epub 2012 Apr 21.
[17]	Gutt CN, Encke J, Köninger J, Harnoss JC, Weigand K, Kipfmüller K, Schunter O, Götze T, Golling MT, Menges M, Klar E, Feilhauer K, Zoller WG, Ridwelski K,Ackmann S, Baron A, Schön MR, Seitz HK, Daniel D, Stremmel W, Büchler MW.: Acute cholecystitis: early versus delayed cholecystectomy, a multicenter randomized trial (ACDC study, NCT00447304) Ann Surg. 2013 Sep;258(3):385-93 doi: 10.1097/SLA.0b013e3182a1599b.
[18]	Gurusamy KS, Davidson C, Gluud C, Davidson BR.: Early versus delayed laparoscopic cholecystectomy for people with acute cholecystitis Cochrane Database Syst Rev. 2013 Jun 30; 6:CD005440 doi: 10.1002/14651858.CD005440.pub3.
[19]	Zhou, M W., X D Gu, et al "Comparison of clinical safety and outcomes of early versus delayed laparoscopic cholecystectomy for acute cholecystitis: a meta-analysis." Scientific World Journal 2014: 274516.
[20]	de Mestral C1, Rotstein OD, Laupacis A, Hoch JS, Zagorski B, Alali AS, Nathens AB Comparative operative outcomes of early and delayed cholecystectomy for acute cholecystitis: a population-based propensity score analysis Ann Surg. 2014 Jan; 259(1):10-5 doi: 10.1097/SLA.0b013e3182a5cf36.
[21]	Sobolev B, Mercer D, Brown P, Fitzgerald M, Jalink D, Shaw R Risk of emergencyadmission while awaiting elective cholecystectomy Can Med Assoc J 2003; 169: 662–5.
[22]	Serralta A, Bueno J, Planells M, Rodero D Prospective evaluation of emergency versus delayed laparoscopic cholecystectomy for early cholecystitis Surg Laparosc Endosc Percutan Tech 2003; 13: 71–5.
[23]	Unger W, Glick G, Landeros M Cystic duct leak after laparoscopic cholecystectomy: a multi-institutional study Surg Endosc 1996; 10: 1189–93.

Cite This Article

Plain Text BibTeX RIS

APA Style

Abdallah M Taha, Mohamed Yousef A., Asmaa Gaber R. (2016). Early Versus Delayed Laparoscopic Cholecystectomy for Uncomplicated Acute Cholecystitis. Journal of Surgery, 4(3-1), 29-33. https://doi.org/10.11648/j.js.s.2016040301.16

Copy | Download

ACS Style

Abdallah M Taha; Mohamed Yousef A.; Asmaa Gaber R. Early Versus Delayed Laparoscopic Cholecystectomy for Uncomplicated Acute Cholecystitis. J. Surg. 2016, 4(3-1), 29-33. doi: 10.11648/j.js.s.2016040301.16

Copy | Download

AMA Style

Abdallah M Taha, Mohamed Yousef A., Asmaa Gaber R. Early Versus Delayed Laparoscopic Cholecystectomy for Uncomplicated Acute Cholecystitis. J Surg. 2016;4(3-1):29-33. doi: 10.11648/j.js.s.2016040301.16

Copy | Download

@article{10.11648/j.js.s.2016040301.16,
  author = {Abdallah M Taha and Mohamed Yousef A. and Asmaa Gaber R.},
  title = {Early Versus Delayed Laparoscopic Cholecystectomy for Uncomplicated Acute Cholecystitis},
  journal = {Journal of Surgery},
  volume = {4},
  number = {3-1},
  pages = {29-33},
  doi = {10.11648/j.js.s.2016040301.16},
  url = {https://doi.org/10.11648/j.js.s.2016040301.16},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.js.s.2016040301.16},
  abstract = {Introduction: Acute cholecystitis is a relatively common complication of gallstones It can lead to significant morbidity and mortality from potentially life-threatening complications such as empyema, gallbladder gangrene and gallbladder perforation It presents as a surgical emergency and usually requires hospitalization for management Laparoscopic cholecystectomy is advocated for acute cholecystitis; however, the timing of cholecystectomy and the value of the additional treatments have been a matter of controversy Aim: To compare the outcome of early versus delayed laparoscopic cholecystectomy in cases of non-complicated acute cholecystitis, as its place remains controversial in the management of acute cholecystitis due to a high reported incidence of bile leaks and conversion rate Design: Prospective interventional comparative study Methods: 120 Patients admitted to Qena and Aswan universities’ hospitals with acute cholecystitis over two years period (2013-2015) were included in this study An early laparoscopic cholecystectomy (ELC), within 7 days from onset of symptoms, for 50 patients, and delayed Laparoscopic cholecystectomy (DLC) after 6 weeks of conservative treatment for 70 patients was performed Demographic details, operative findings, conversion to open surgery, operative time, complications, timing of endoscopic retrograde cholangiopancreatography (ERCP) and hospital stay for all those patients were recorded Statistical analysis was performed by SPSS version 18 Results: There was insignificant difference in the conversion rates (2 in ELC group versus 2 DLC group, p value: 0.555), post-operative hospital stay (2 days vs 1.5days, p value: 0.375) However, operative time was significantly more in the ELC group (85 minutes versus 70 minutes, p value: 0.023) Postoperative ERCP was required in 2 patients in ELC group and one patient in DLC group Pre-operative ERCP was required in 2 patients in delayed group 40% of patients (48) had previous admissions with similar symptoms Conclusion: ELC for uncomplicated acute cholecystitis is technically demanding surgery, but it is safe and do not have increased complication rate than DLC It decreases re-admission rate and overall hospital stay.},
 year = {2016}
}

Copy | Download

TY  - JOUR
T1  - Early Versus Delayed Laparoscopic Cholecystectomy for Uncomplicated Acute Cholecystitis
AU  - Abdallah M Taha
AU  - Mohamed Yousef A.
AU  - Asmaa Gaber R.
Y1  - 2016/04/18
PY  - 2016
N1  - https://doi.org/10.11648/j.js.s.2016040301.16
DO  - 10.11648/j.js.s.2016040301.16
T2  - Journal of Surgery
JF  - Journal of Surgery
JO  - Journal of Surgery
SP  - 29
EP  - 33
PB  - Science Publishing Group
SN  - 2330-0930
UR  - https://doi.org/10.11648/j.js.s.2016040301.16
AB  - Introduction: Acute cholecystitis is a relatively common complication of gallstones It can lead to significant morbidity and mortality from potentially life-threatening complications such as empyema, gallbladder gangrene and gallbladder perforation It presents as a surgical emergency and usually requires hospitalization for management Laparoscopic cholecystectomy is advocated for acute cholecystitis; however, the timing of cholecystectomy and the value of the additional treatments have been a matter of controversy Aim: To compare the outcome of early versus delayed laparoscopic cholecystectomy in cases of non-complicated acute cholecystitis, as its place remains controversial in the management of acute cholecystitis due to a high reported incidence of bile leaks and conversion rate Design: Prospective interventional comparative study Methods: 120 Patients admitted to Qena and Aswan universities’ hospitals with acute cholecystitis over two years period (2013-2015) were included in this study An early laparoscopic cholecystectomy (ELC), within 7 days from onset of symptoms, for 50 patients, and delayed Laparoscopic cholecystectomy (DLC) after 6 weeks of conservative treatment for 70 patients was performed Demographic details, operative findings, conversion to open surgery, operative time, complications, timing of endoscopic retrograde cholangiopancreatography (ERCP) and hospital stay for all those patients were recorded Statistical analysis was performed by SPSS version 18 Results: There was insignificant difference in the conversion rates (2 in ELC group versus 2 DLC group, p value: 0.555), post-operative hospital stay (2 days vs 1.5days, p value: 0.375) However, operative time was significantly more in the ELC group (85 minutes versus 70 minutes, p value: 0.023) Postoperative ERCP was required in 2 patients in ELC group and one patient in DLC group Pre-operative ERCP was required in 2 patients in delayed group 40% of patients (48) had previous admissions with similar symptoms Conclusion: ELC for uncomplicated acute cholecystitis is technically demanding surgery, but it is safe and do not have increased complication rate than DLC It decreases re-admission rate and overall hospital stay.
VL  - 4
IS  - 3-1
ER  -

Copy | Download

Author Information

Abdallah M Taha

Department of General Surgery, Faculty of Medicine, South Valley University, Qena, Egypt
Mohamed Yousef A.

Department of General Surgery, Faculty of Medicine, Aswan University, Aswan, Egypt
Asmaa Gaber R.

Department of General Surgery, Faculty of Medicine, South Valley University, Qena, Egypt

Download PDF

Sections

Plain Text BibTeX RIS

APA Style

Abdallah M Taha, Mohamed Yousef A., Asmaa Gaber R. (2016). Early Versus Delayed Laparoscopic Cholecystectomy for Uncomplicated Acute Cholecystitis. Journal of Surgery, 4(3-1), 29-33. https://doi.org/10.11648/j.js.s.2016040301.16

Copy | Download

ACS Style

Abdallah M Taha; Mohamed Yousef A.; Asmaa Gaber R. Early Versus Delayed Laparoscopic Cholecystectomy for Uncomplicated Acute Cholecystitis. J. Surg. 2016, 4(3-1), 29-33. doi: 10.11648/j.js.s.2016040301.16

Copy | Download

AMA Style

Abdallah M Taha, Mohamed Yousef A., Asmaa Gaber R. Early Versus Delayed Laparoscopic Cholecystectomy for Uncomplicated Acute Cholecystitis. J Surg. 2016;4(3-1):29-33. doi: 10.11648/j.js.s.2016040301.16

Copy | Download

@article{10.11648/j.js.s.2016040301.16,
  author = {Abdallah M Taha and Mohamed Yousef A. and Asmaa Gaber R.},
  title = {Early Versus Delayed Laparoscopic Cholecystectomy for Uncomplicated Acute Cholecystitis},
  journal = {Journal of Surgery},
  volume = {4},
  number = {3-1},
  pages = {29-33},
  doi = {10.11648/j.js.s.2016040301.16},
  url = {https://doi.org/10.11648/j.js.s.2016040301.16},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.js.s.2016040301.16},
  abstract = {Introduction: Acute cholecystitis is a relatively common complication of gallstones It can lead to significant morbidity and mortality from potentially life-threatening complications such as empyema, gallbladder gangrene and gallbladder perforation It presents as a surgical emergency and usually requires hospitalization for management Laparoscopic cholecystectomy is advocated for acute cholecystitis; however, the timing of cholecystectomy and the value of the additional treatments have been a matter of controversy Aim: To compare the outcome of early versus delayed laparoscopic cholecystectomy in cases of non-complicated acute cholecystitis, as its place remains controversial in the management of acute cholecystitis due to a high reported incidence of bile leaks and conversion rate Design: Prospective interventional comparative study Methods: 120 Patients admitted to Qena and Aswan universities’ hospitals with acute cholecystitis over two years period (2013-2015) were included in this study An early laparoscopic cholecystectomy (ELC), within 7 days from onset of symptoms, for 50 patients, and delayed Laparoscopic cholecystectomy (DLC) after 6 weeks of conservative treatment for 70 patients was performed Demographic details, operative findings, conversion to open surgery, operative time, complications, timing of endoscopic retrograde cholangiopancreatography (ERCP) and hospital stay for all those patients were recorded Statistical analysis was performed by SPSS version 18 Results: There was insignificant difference in the conversion rates (2 in ELC group versus 2 DLC group, p value: 0.555), post-operative hospital stay (2 days vs 1.5days, p value: 0.375) However, operative time was significantly more in the ELC group (85 minutes versus 70 minutes, p value: 0.023) Postoperative ERCP was required in 2 patients in ELC group and one patient in DLC group Pre-operative ERCP was required in 2 patients in delayed group 40% of patients (48) had previous admissions with similar symptoms Conclusion: ELC for uncomplicated acute cholecystitis is technically demanding surgery, but it is safe and do not have increased complication rate than DLC It decreases re-admission rate and overall hospital stay.},
 year = {2016}
}

Copy | Download

TY  - JOUR
T1  - Early Versus Delayed Laparoscopic Cholecystectomy for Uncomplicated Acute Cholecystitis
AU  - Abdallah M Taha
AU  - Mohamed Yousef A.
AU  - Asmaa Gaber R.
Y1  - 2016/04/18
PY  - 2016
N1  - https://doi.org/10.11648/j.js.s.2016040301.16
DO  - 10.11648/j.js.s.2016040301.16
T2  - Journal of Surgery
JF  - Journal of Surgery
JO  - Journal of Surgery
SP  - 29
EP  - 33
PB  - Science Publishing Group
SN  - 2330-0930
UR  - https://doi.org/10.11648/j.js.s.2016040301.16
AB  - Introduction: Acute cholecystitis is a relatively common complication of gallstones It can lead to significant morbidity and mortality from potentially life-threatening complications such as empyema, gallbladder gangrene and gallbladder perforation It presents as a surgical emergency and usually requires hospitalization for management Laparoscopic cholecystectomy is advocated for acute cholecystitis; however, the timing of cholecystectomy and the value of the additional treatments have been a matter of controversy Aim: To compare the outcome of early versus delayed laparoscopic cholecystectomy in cases of non-complicated acute cholecystitis, as its place remains controversial in the management of acute cholecystitis due to a high reported incidence of bile leaks and conversion rate Design: Prospective interventional comparative study Methods: 120 Patients admitted to Qena and Aswan universities’ hospitals with acute cholecystitis over two years period (2013-2015) were included in this study An early laparoscopic cholecystectomy (ELC), within 7 days from onset of symptoms, for 50 patients, and delayed Laparoscopic cholecystectomy (DLC) after 6 weeks of conservative treatment for 70 patients was performed Demographic details, operative findings, conversion to open surgery, operative time, complications, timing of endoscopic retrograde cholangiopancreatography (ERCP) and hospital stay for all those patients were recorded Statistical analysis was performed by SPSS version 18 Results: There was insignificant difference in the conversion rates (2 in ELC group versus 2 DLC group, p value: 0.555), post-operative hospital stay (2 days vs 1.5days, p value: 0.375) However, operative time was significantly more in the ELC group (85 minutes versus 70 minutes, p value: 0.023) Postoperative ERCP was required in 2 patients in ELC group and one patient in DLC group Pre-operative ERCP was required in 2 patients in delayed group 40% of patients (48) had previous admissions with similar symptoms Conclusion: ELC for uncomplicated acute cholecystitis is technically demanding surgery, but it is safe and do not have increased complication rate than DLC It decreases re-admission rate and overall hospital stay.
VL  - 4
IS  - 3-1
ER  -

Copy | Download