Early Versus Delayed Laparoscopic Cholecystectomy in Acute Cholecystitis: A Comparative Study.

BACKGROUND

Laparoscopic cholecystectomy is the gold standard for treating symptomatic cholelithiasis. However, the optimal timing of surgery in acute calculous cholecystitis remains a subject of debate. This study aims to compare early versus delayed laparoscopic cholecystectomy to determine the timing that yields better clinical outcomes.

METHODS

A prospective comparative study was conducted on 100 patients diagnosed with acute calculous cholecystitis at a tertiary healthcare centre in Punjab, India. Patients were randomized into two groups: Group A underwent early laparoscopic cholecystectomy within 72 hours of symptom onset, while Group B underwent delayed surgery after six to eight weeks of conservative management. Parameters analyzed included demographic data, intraoperative findings, and postoperative outcomes. Statistical analysis was performed to assess significance.

RESULTS

Both groups were comparable in age and gender distribution. Mean operative time did not show a significant difference between groups (p = 0.802). Intraoperative adhesions (24% vs. 18%) and gallbladder rupture (12% vs. 6%) were more frequent in Group A, though not statistically significant. Conversion to open surgery was higher in Group A (8%) compared to Group B (2%), but the difference was not significant (p = 0.359). No biliary tract injuries occurred in either group. Postoperative hospital stay was significantly longer in Group A (3.46 ± 0.54 days) compared to Group B (3.06 ± 0.24 days, p < 0.001).

CONCLUSIONS

Early laparoscopic cholecystectomy is a safe and viable option in acute cholecystitis. However, delayed surgery may be associated with marginally lower intraoperative complications and a shorter postoperative hospital stay, suggesting potential benefits in selected cases.