Early laparoscopic cholecystectomy now the gold standard for acute cholecystitis - a comparative study on our experience

Aim: To determine if early laparoscopic cholecystectomy (LC) or delayed laparoscopic cholecystectomy (LC) is gold standard in our experience in Acute Cholecystitis. Methodology: The study was conducted in Department of General Surgery in Vinayaka Missions Karaikal under same surgical team.We compared surgical difficulties, clinical courses and complications between 20 patients undergoing delayed LC and 25 undergoing early LC. Results: We came to a conclusion that Delayed LC was associated with more surgical difficulties than early LC, including severe adhesion of the greater omentum (17/ 20vs. 2/25), severe cicatrization of Calot’s triangle (15/20 vs. 1/25), inability to identify or skeletonize the cystic duct (18/20 vs. 3/25), and severe cicatrization of the gallbladder bed (17/20vs. 1/25). Delayed LC was also associated with longer operating times (180 vs. 90 minutes), more conversions to open surgery (3/20 vs. 0/25), more complications (4/20 vs. 1/25), and longer hospitalization (16 vs. 8 days). Conclusion: From our study it is found that it is high time to make early laparoscopic Cholecystectomy the treatment of choice for acute cholecystitis from delayed laparoscopic cholecystectomy as it can effectively reduce operation time, duration of symptoms and hospital stay, and thus be of significant benefit to patients.