Comparison between outcome of early and delayed laparoscopic surgery in patients with acute cholecystitis – A prospective randomized controlled trial.

Abstract

Objective: To determine the comparison between outcome of early and delayed laparoscopic cholecystectomy among patients presenting with acute cholecystitis. Study Design: Prospective Randomized Controlled Trial. Setting: Dr. Akbar Niazi Teaching Hospital, Islamabad. Period: September 2022 to February 2023. Material & Methods: Total 108 patients (54 in each group) were included in the study. Group-A planned for surgery before 7 days of onset of symptoms, while Group-B planned for surgery after 7 days of onset of symptoms. The outcomes were measured in terms of hospital stay and operating time. Results: Patient’s age range was 15-60 years with mean age of 40.8±12.6 and 42.2±12.8 years in group-A and B, respectively. Conversion to open cholecystectomy, bile duct injury, surgical site infection and hypertension were comparable in both groups. Mean hospital stay in group-A was 9.26±2.43 and in group-B 15.41±3.37 days (p = 0.001). Mean operating time was significantly less in group-A as compared to group-B (64.93±6.68 vs 72.78±8.03 min; p = 0.001). Stratification with regard to gender and hypertension was significant (p ≤ 0.05), whereas stratification with regard to age and surgical site infection was insignificant (p ≥ 0.05). Conclusion: Early laparoscopic cholecystectomy is safe and associated with less complications and lower conversion rates as compared to late cholecystectomy for acute cholecystitis.