Complications associated with late acute cholecystectomy.

INTRODUCTION

Gallstone-related diseases are common in Denmark, with acute cholecystitis being a painful presentation. Historically, cholecystectomy was performed within five days of symptom onset. In 2022, national guidelines abandoned this limit due to evidence suggesting similar outcomes for early and delayed surgery. This study aimed to assess the impact of an extended surgical window on the frequency of acute cholecystitis operations, complication rates and patient outcomes.

METHODS

All cholecystectomies performed between 1 June 2022 and 31 May 2023 were identified using the procedural codes KJKA20 and KJKA21. Patients with gallstone pancreatitis, biliary colic or choledocholithiasis were excluded. Medical records were reviewed, and a statistical analysis was conducted.

RESULTS

Among 180 patients identified, 128 met the inclusion criteria. Thirty-nine patients had > 5 days of symptoms at the time of surgery. No significant differences were observed in operative duration, hospital stay, reoperation, conversion to open surgery or mortality. However, complications graded Clavien-Dindo > 1 were more frequent in the group with a duration of > 5 days (28.2% versus 10.1%, p = 0.009). Multivariate analysis showed that long symptom duration and older age were associated with an increased risk (p less-than 0.05).

CONCLUSIONS

Extended symptom duration before surgery was associated with a higher rate of post-operative complications. Larger, multicentre studies are needed to confirm these findings and guide clinical decisions.

FUNDING: None.

TRIAL REGISTRATION: Not relevant.