LAPAROSCOPIC CHOLECYSTECTOMY

OPTIMAL TIMING FOR SURGERY IN ACUTE GALL STONE DISEASE

Abstract

Laparoscopic cholecystectomy is the gold standard treatment for patients presenting with acute gall stone disease necessitating hospital admission. Objective: To assess the impact of timing of laparoscopic cholecystectomy on conversion rate, hospital stay and morbidity. Period: Jan 2008-2010. Setting: Department of Surgery, Independent University Hospital, Faisalabad. Study Design: Experimental study. Material & Methods: The subjects were included by consecutive sampling technique. 81 cases were divided into 3 groups. Group A (Surgery within 72 hrs of onset symptoms). Group B (surgery between 72hrs to 96 hours of onset of symptoms). Group C (surgery after 96 hours of onset of symptoms). Results: The mean age was 41-95 years. Female to male ratio was 4.5:1. The overall complication rate was 12.69%. Mean hospital stay was 2.85 days. The open conversion rate was 8.64%. In group A the complication rate was 6%, group B 11.5% and group C 12.8&. The mean hospital stay and conversion rate had no significant difference. Conclusions: The timing of laparoscopic cholecystectomy has no significant impact on the conversion rate and length of hospital stay in cases with acute cholecystitis. However the complication rate was higher when surgery performed after 72 hours of onset of symptoms.