scholarly journals LAPAROSCOPIC CHOLECYSTECTOMY;

2013 ◽  
Vol 20 (02) ◽  
pp. 313-318
Author(s):  
MOHAMMAD ADNAN NAZEER ◽  
HASAAN IMTIAZ ◽  
HARUN MAJID DAR ◽  
Zulfiqar Ali ◽  
Asma Samreen
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Acute Cholecystitis ◽  
Controlled Trial ◽  
Early Laparoscopic Cholecystectomy ◽  
Delayed Cholecystectomy ◽  
Laparoscopic Cholecystectomy Group ◽  
Delayed Laparoscopic Cholecystectomy ◽  
Delayed Group ◽  
Group 2 ◽  
Group 1

Introduction: The role of laparoscopic cholecystectomy in treatment of acute cholecystitis is still controversial. Objective:The objective of this prospective randomized controlled trial was to evaluate the outcomes of early laparoscopic cholecystectomy foracute cholecystitis and to compare the results with delayed cholecystectomy. Setting: Sheikh Zayed Hospital, Lahore. Period: 1st Feb,2012 to 31st July 2012. Materials & Methods: 60 diagnosed patients of acute cholecystitis were randomly allocated to two groups,Group 1 underwent early laparoscopic cholecystectomy (Group 1, n = 30) and Group 2 to initial conservative treatment followed bydelayed laparoscopic cholecystectomy, 6 to 12 weeks later (Group 2 , n = 30). Results: The overall complication rate was 3.3% (01) inearly group and 16.7% (05) in the delayed group. There was no common bile duct injury in both groups. The complications includedwound infection and intraperitoneal collection. Conclusions: According to the results our study we concluded that early laparoscopiccholecystectomy can safely be carried out for acute cholecystitis as the complications for early laparoscopic cholecystectomy are lessas compared to delayed laparoscopic cholecystectomy. Early laparoscopic cholecystectomy has also an edge over delayed because ofsingle hospital stay.

Time to abandon the old dictum of delayed laparoscopic cholecystectomy after acute cholecystitis has settled in Caribbean practice

2021 ◽  
pp. 004947552110100
Author(s):  
Shamir O Cawich ◽  
Avidesh H Mahabir ◽  
Sahle Griffith ◽  
Patrick FaSiOen ◽  
Vijay Naraynsingh
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Acute Cholecystitis ◽  
Gold Standard ◽  
Standard Treatment ◽  
Gallstone Disease ◽  
Acute Attack ◽  
Early Laparoscopic Cholecystectomy ◽  
Delayed Surgery ◽  
Delayed Cholecystectomy ◽  
Delayed Laparoscopic Cholecystectomy

Although laparoscopic cholecystectomy is the gold standard treatment for acute cholecystitis, many Caribbean surgeons are reluctant to operate during the acute attack. We collected data for all consecutive patients who underwent laparoscopic cholecystectomy for acute cholecystitis from January 1 to 31 December 2018. Delayed cholecystectomy was done >6 weeks after acute cholecystitis settled. We compared data between early and delayed groups. Delayed laparoscopic cholecystectomy was performed in 54 patients, and 42 had early laparoscopic cholecystectomy. Delayed surgery resulted in significantly more complications requiring readmission (39% vs 0), longer operations (2.27 vs 0.94 h) and lengthier post-operative hospitalisation (1.84 vs 1.1 days). Caribbean hospitals should abandon the practice of delayed surgery after cholecystitis has settled. Early laparoscopic cholecystectomy would be financially advantageous for our institutions, and it would save patients recurrent attacks of gallstone disease.

scholarly journals Early Versus Delayed Laparoscopic Cholecystectomy for Acute Cholecystitis: A Prospective, Randomized Study

2014 ◽  
Vol 99 (1) ◽  
pp. 56-61 ◽  
Author(s):  
Alper Bilal Özkardeş ◽  
Mehmet Tokaç ◽  
Ersin Gürkan Dumlu ◽  
Birkan Bozkurt ◽  
Ahmet Burak Çiftçi ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Postoperative Complications ◽  
Hospital Stay ◽  
Acute Cholecystitis ◽  
Operation Time ◽  
Early Laparoscopic Cholecystectomy ◽  
Laparoscopic Cholecystectomy Group ◽  
Delayed Laparoscopic Cholecystectomy ◽  
Significant Difference ◽  
Conversion To Open Cholecystectomy

Abstract We aimed to compare the clinical outcome and cost of early versus delayed laparoscopic cholecystectomy for acute cholecystitis. Sixty patients with acute cholecystitis were randomized into early (within 24 hours of admission) or delayed (after 6–8 weeks of conservative treatment) laparoscopic cholecystectomy groups. There was no significant difference between study groups in terms of operation time and rates for conversion to open cholecystectomy. On the other hand, total hospital stay was longer (5.2 ± 1.40 versus 7.8 ± 1.65 days; P = 0.04) and total costs were higher (2500.97 ± 755.265 versus 3713.47 ± 517.331 Turkish Lira; P = 0.03) in the delayed laparoscopic cholecystectomy group. Intraoperative and postoperative complications were recorded in 8 patients in the early laparoscopic cholecystectomy group, whereas no complications occurred in the delayed laparoscopic cholecystectomy group (P = 0.002). Despite intraoperative and postoperative complications being associated more with early laparoscopic cholecystectomy compared with delayed intervention, early laparoscopic cholecystectomy should be preferred for treatment of acute cholecystitis because of its advantages of shorter hospital stay and lower cost.

scholarly journals Evaluation of Early versus Delayed Laparoscopic Cholecystectomy in Acute Cholecystitis

2015 ◽  
Vol 2015 ◽  
pp. 1-7 ◽  
Author(s):  
Rati Agrawal ◽  
K. C. Sood ◽  
Bhupender Agarwal
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Hospital Stay ◽  
Acute Cholecystitis ◽  
Randomized Study ◽  
Group Versus ◽  
Operation Time ◽  
Early Group ◽  
Early Laparoscopic Cholecystectomy ◽  
Delayed Laparoscopic Cholecystectomy ◽  
Delayed Group

Background. The role of early laparoscopic cholecystectomy for acute cholecystitis with cholelithiasis is not yet established. The aim of our prospective randomized study was to evaluate the safety and feasibility of early LC for acute cholecystitis and to compare the results with delayed LC.Methods. Between March 2007 to December 2008, 50 patients with diagnosis of acute cholecystitis were assigned randomly to early group,n=25(LC within 24 hrs of admission), and delayed group,n=25(initial conservative treatment followed by delayed LC, 6–8 weeks later).Results. We found in our study that the conversion rate in early LC and delayed LC was 16% and 8%, respectively, Operation time for early LC was 69.4 min versus 66.4 min for delayed LC, postoperative complications for early LC were 24% versus 8% for delayed LC, and blood loss was 159.6 mL early group versus 146.8 mL for delayed group. However early LC had significantly shorter hospital stay (4.1 days versus 8.6 days).Conclusions. Early LC for acute cholecystitis with cholelithiasis is safe and feasible, offering the additional benefit of shorter hospital stay. It should be offered to the patients with acute cholecystitis, provided that the surgery is performed within 96 hrs of acute symptoms by an experienced surgeon.

scholarly journals An evaluation of early and delayed laparoscopic cholecystectomy for acute cholecystitis

2019 ◽  
Vol 6 (9) ◽  
pp. 3147
Author(s):  
M. Zaid Imbisat ◽  
S. A. A. Rizvi ◽  
Imad Ali
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Acute Cholecystitis ◽  
Gall Stone ◽  
Gallbladder Perforation ◽  
Early Group ◽  
Early Laparoscopic Cholecystectomy ◽  
Total Hospital Stay ◽  
Delayed Laparoscopic Cholecystectomy ◽  
Duration Of Surgery ◽  
Delayed Group

Background: Acute cholecystitis is one of the hepatopancreatobiliary emergencies. With more and more experience in the laparoscopic cholecystectomy studies are being carried out evaluating the effectiveness and feasibility of early laparoscopic cholecystectomy in acute cholecystitis.Methods: Fifty patients presenting with acute cholecystitis were included in this study and randomized using chit in the box method into two groups- early group and delayed group.Results: Mean duration of surgery in the early group is 42.28±5.99 mins and in the delayed group is 39.12±5.55 mins (p=0.06). Gallbladder perforation was reported in 4 patients (16%) in early group and in 2 patients (8%) in delayed group (p=0.67). Gall stone spillage was reported in 3 patients (12%) in early group and in 2 patients (8%) in delayed group (p=1.00). At 6th hr mean VAS (visual analogue scale) score in the early group was 4.0±0.41 and in the delayed group it was 3.6±0.58 (p=0.01). At 12th hr mean VAS score in the early group was 3.4±0.51 and in the delayed group it was 3.3±0.48 (p=0.39). Mean duration of postoperative stay was 2.24±0.60 days in early group and in the delayed group it was 2.08±0.57 days (p=0.34).Conclusions: It has been found that early laparoscopic cholecystectomy is safe and feasible in the setting of acute cholecystitis with added advantage of shorter total hospital stay.

Hospital Enforcement of Early Cholecystectomy for Acute Cholecystitis

2019 ◽  
Vol 85 (8) ◽  
pp. 858-860
Author(s):  
April Cockcroft ◽  
Elizabeth Verrico ◽  
Shirley Xing ◽  
Seth Westerman ◽  
Matthew Jung ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Acute Cholecystitis ◽  
Elective Surgery ◽  
Controlled Trial ◽  
Retrospective Chart Review ◽  
Signs And Symptoms ◽  
International Guidelines ◽  
Early Laparoscopic Cholecystectomy ◽  
Delayed Laparoscopic Cholecystectomy ◽  
Hospital Stays

International guidelines state that early laparoscopic cholecystectomy (ELC) is appropriate for all severity grades of acute cholecystitis and leads to reduced hospital stays and costs. A multicenter prospective randomized controlled trial recommends ELC over delayed laparoscopic cholecystectomy (DLC) management because in addition to reduced hospital stays and costs, ELC also leads to reduced patient morbidity. Therefore, ELC is standard of care for acute cholecystitis. We hypothesize that 1) international guidelines are not presently followed and that 2) a quality improvement (QI) project enforcing ELC for acute cholecystitis will increase rates of ELC management. A retrospective chart review of all surgical consults for cholecystitis from January 2016 to December 2018 was undertaken. A total of 307 patients diagnosed with acute cholecystitis were included. ELC was defined as cholecystectomy within hospital admission. Pre-QI ELC versus DLC rates were 77.4 per cent (233/301) versus 22.6 per cent (68/301). Eight DLC patients (11.8%) returned to the ED after discharge secondary to persistent signs and symptoms of cholecystitis and 62.5 per cent (5/8) received an immediate cholecystectomy before their elective surgery date. After QI initiatives, ELC rates rose to 100 per cent (6/6). These data show there was a lack of consistent ELC management of acute cholecystitis.

scholarly journals Early versus delayed laparoscopic cholecystectomy for acute cholecystitis: a comparative study

2018 ◽  
Vol 5 (10) ◽  
pp. 3381
Author(s):  
Rahul Chhajed ◽  
Ramesh Dumbre ◽  
Arun Fernandes ◽  
Deepak Phalgune
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Laparoscopic Surgery ◽  
Postoperative Complications ◽  
Hospital Stay ◽  
Acute Cholecystitis ◽  
Outcome Measures ◽  
Early Laparoscopic Cholecystectomy ◽  
Surgery Group ◽  
Laparoscopic Cholecystectomy Group ◽  
Delayed Laparoscopic Cholecystectomy

Background: Laparoscopic cholecystectomy is now the procedure of choice for patient presenting with acute cholecystitis unless it is contraindicated for technical reason or safety. An attempt was made to compare the outcome and postoperative complications of early vs delayed laparoscopic cholecystectomy in acute cholecystitis.Methods: Fifty patients aged 18 to 64 years having acute cholecystitis admitted for laparoscopic cholecystectomy were included. They were divided into two groups, early (less than 72 hours) and delayed (more than 72 hours up to 6 weeks) laparoscopic cholecystectomy. The patients were followed for three months after the surgery. The primary outcome measures were conversion to open surgery and postoperative complications whereas secondary outcome measures were hospital stay and return to full activity. Comparison of quantitative variables and qualitative variables was done using unpaired student’s “t” test and chi-square test/ Fisher’s exact test respectively.Results: Conversion to open cholecystectomy (p = 0.007) and post-operative complications (p = 0.032) were significantly less in early laparoscopic cholecystectomy group compared to delayed laparoscopic cholecystectomy group. Mean days of hospital stay (4.9 versus 7.4 with p = 0.001) and mean days of return to full activities (12.6 vs 16.3 days with p = 0.001) was significantly less in early laparoscopic surgery group compared to delayed laparoscopic cholecystectomy group. Mean duration of surgery was significantly less in early laparoscopic surgery group as compared to delayed laparoscopic surgery group (69.3 versus 108.5 minutes, with p = 0.001).Conclusions: Early laparoscopic cholecystectomy is better choice than delayed laparoscopic cholecystectomy in acute cholecystitis.

scholarly journals Comparison of Early and Delayed Laparoscopic Cholecystectomy in Acute Cholecystitis

2021 ◽  
Vol 15 (1) ◽  
pp. 91-94
Author(s):  
Muhammad Nasir ◽  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Acute Cholecystitis ◽  
Open Cholecystectomy ◽  
Early Laparoscopic Cholecystectomy ◽  
Female Patients ◽  
Delayed Laparoscopic Cholecystectomy ◽  
Conversion To Open Cholecystectomy ◽  
Group A ◽  
Male Patients ◽  
Group B

Background: Laparoscopic Cholecystectomy is now accepted as being safe for acute cholecystitis. However, it has not become routine, because the exact timing and approach to the surgical management remains ill define. Careful selection of patients, the knowledge of typical procedure-related complications, and their best treatment are the key points for a safe Laparoscopic Cholecystectomy. Objective: To compare the early and delayed Laparoscopic Cholecystectomy in the acute phase in terms of frequency of conversion to open cholecystectomy. Study Design: Randomized clinical trial. Settings: Department of Surgery, Divisional Headquarter Hospital, Faisalabad. Punjab Medical College, Faisalabad Pakistan. Duration: Study was carried out over a period of six months from June 2018 to May 2019. Methodology: A total of 152 cases (76 cases in each group) were included in this study. All patients were randomly allocated to either group i.e., group -A early Laparoscopic Cholecystectomy and group-B delayed Laparoscopic Cholecystectomy. Results: Mean age was 39.09 + 8.8 and 37.05+ 8.5 years in group- A and B, respectively. In group-A, male patients were 48 (63.2%) and female patients were 28 (36.8%). Similarly, in group-B, male patients were 41 (53.9%) and female patients were 35 (46.1%). Conversion to open cholecystectomy was required in 6 patients (7.9%) of group-A and 16 patients (21.0%) of group – B. Significant difference between two groups was observed (P= 0.021). Conclusion: Early laparoscopic cholecystectomy for acute cholecystitis is safe and feasible in terms of less frequency of conversion to open cholecystectomy.

Early Versus Delayed Laparoscopic Cholecystectomy in Cases of Acute Calcular Cholecystitis

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Mohammed Mohammed Bahaa El-Din ◽  
Hany Rafik Halim ◽  
Mohammed Abd El-Sattar Abd El-Hamid ◽  
Mohammed Safwat Abd El-Razek
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Hospital Stay ◽  
Acute Cholecystitis ◽  
Randomized Study ◽  
Operation Time ◽  
The United States ◽  
Optimal Timing ◽  
University Hospitals ◽  
Early Laparoscopic Cholecystectomy ◽  
Delayed Laparoscopic Cholecystectomy

Abstract Background Acute cholecystitis (AC) is one of the important causes of abdominal pain on presentation to the emergency department. Early diagnosis and treatment of AC has a positive effect on morbidity and mortality. Laparoscopic cholecystectomy (LC) is an important approach for treating acute cholecystitis nowadays. Issued data indicated that approximately 917,000 and >50,000 LCs were annually performed to treat acute cholecystitis in the United States and England, respectively. Although LCs have been extensively performed to manage acute cholecystitis, the optimal timing of LC for this given condition is inconclusive. Aim of the work The aim of this study is to prospectively compare between early and delayed laparoscopic cholecystectomy as a management of acute calcular cholecystitis along with their operative and post-operative outcomes. Patients and methods From December 2019 to December 2020 in Ain Shams University Hospitals, a prospective randomized study was conducted over 20 patients of acute cholecystitis: 10 of them underwent laparoscopic cholecystectomy from 3 day to 7 day of symptoms of acute cholecystitis, and the other 15 after 6- 8 weeks. Operation time, intraoperative and postoperative surgical complications and duration of hospital stay were assessed and compared in the 2 groups. Results Although the operation time was longer in the group with early laparoscopic cholecystectomy, but the overall complications along with the total hospital stay were less in this group of patients. Conclusion Early timing of laparoscopic cholecystectomy in relation to the onset of gall bladder inflammation may reduce the conversion rate and the total complication rate. So, early laparoscopic cholecystectomy for patients with acute cholecystitis has both medical and socioeconomic benefits and it is the preferred approach in comparison to delayed approach.

scholarly journals A comparative study of early vs. delayed laparoscopic cholecystectomy in acute cholecystitis

1970 ◽  
Vol 7 (1) ◽  
pp. 16-20 ◽  
Author(s):  
RP Yadav ◽  
S Adhikary ◽  
CS Agrawal ◽  
B Bhattarai ◽  
RK Gupta ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Hospital Stay ◽  
Acute Cholecystitis ◽  
Open Cholecystectomy ◽  
Total Leukocyte Count ◽  
Early Group ◽  
Duration Of Symptoms ◽  
Delayed Laparoscopic Cholecystectomy ◽  
Delayed Group ◽  
The Mean

Aims and Objectives: To compare the outcome in early vs. delayed laparoscopic cholecystectomy in terms of frequency of intra-operative and postoperative complications and to determine the rate and reasons for conversion. Materials and methods: A prospective randomized clinical trial was performed in the Department of Surgery at BP Koirala Institute of Health Sciences from February 2003 to June 2004 in all patients with the diagnosis of acute calculus cholecystitis. Results: Out of 145 cases, 50 cases were included in our study where 12 (24%) patients were males and 38 (76%) were females (M:F=1:3.16). The mean (SD) age of patients in early and delayed groups were 42.68 yrs. (14.18) and 40.26 yrs. (11.62) respectively. The mean (SD) duration of symptoms in early successful and converted groups were 109.24 hrs. (43.66) and 132 hrs. (49.96) respectively and the mean (SD) duration of symptoms in delayed successful and converted groups were 15.36 months (13.88) and 41 months (40.73) respectively. In early group, 17 (68%) patients had total leukocyte count more than 10,000/cmm and they had ultrasound findings suggestive of acute cholecystitis. Out of 25 patients in early group, seven had jaundice and ten had deranged liver function in the preoperative period. In early group 4 (16%) patients; and in delayed group 3 (12%) had to be converted to open cholecystectomy (P=1.00). In early group 10 (40%) and in delayed 5 (20 %) cases had intra-operative complications (P=0.122). The total hospital stay was longer in the delayed group. The postoperative hospital stay in early and delayed converted groups were higher than early and delayed successful group (P=0.081, P=0.082). Conclusion: Both early and delayed laparoscopic cholecystectomy is possible and safe in the treatment of acute cholecystitis. Key words: Acute cholecystitis, Laparoscopic cholecystectomy, Conversion doi: 10.3126/kumj.v7i1.1759       Kathmandu University Medical Journal (2009), Vol. 7, No. 1, Issue 25, 16-20   

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