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. 2025 Feb 14;17(2):e78985.
doi: 10.7759/cureus.78985. eCollection 2025 Feb.

Comparative Analysis of Complications in Early Verses Delayed Laparoscopic Cholecystectomy for Acute Cholecystitis

Muhammad Iftikhar  1 , Maria Seereen Qazi  2 , Rashid Khan  1 , Sadeeq Ahmad  1 , Sifat Ullah  1 , Farman Ullah  1
Affiliations

Comparative Analysis of Complications in Early Verses Delayed Laparoscopic Cholecystectomy for Acute Cholecystitis

Muhammad Iftikhar et al. Cureus. .

Abstract

Background: Acute cholecystitis (AC) is one of the most frequent gastrointestinal emergencies, necessitating prompt definitive treatment. Laparoscopic cholecystectomy (LC) has become the gold standard for management, although the timing of surgery remains controversial. Early laparoscopic cholecystectomy (ELC) is performed within 72 hours of symptom onset, while delayed laparoscopic cholecystectomy (DLC) is undertaken after a period of conservative management. The purpose of this study is to assess the complications and outcomes of early vs delayed laparoscopic cholecystectomy in patients with acute cholecystitis.

Objectives: To evaluate perioperative outcomes, including complications, operative time, conversion rates, and hospital stay, between patients undergoing early vs delayed laparoscopic cholecystectomy for acute cholecystitis.

Material and methods: This prospective non-randomized comparative study was conducted in the surgical department of Hayatabad Medical Complex (HMC), Peshawar. The study was carried out during a 15-month period, from June 1, 2023, to August 30, 2024. A total of 118 individuals with acute cholecystitis, age ranged between 18 to 60 years, were included. Acute cholecystitis was diagnosed based on imaging examinations, laboratory tests, and the patient's history.

Results: In Group 1, the mean age of patients was 42.5±10.3 years, and it was 44.1±9.8 years in Group 2. Gender distribution was similar in both groups, with a slight predominance of females (Group 1: 35 females, 25 males; Group 2: 34 females, 24 males). In Group 1, the most common presenting symptoms were right upper quadrant pain (55, 92.4%), nausea (47, 78.8%), and fever (27, 45.8%). Similarly, in Group 2, these symptoms were reported in 53 (91.4%), 46 (79.3%), and 27 (46.6%) patients, respectively. Duration of symptoms prior to surgery was 3.2±1.1 days in Group 1 and 4.1±1.3 days in Group 2.

Conclusions: In comparison to delayed laparoscopic cholecystectomy, early laparoscopic cholecystectomy is associated with fewer complications, fewer readmissions, and shorter hospital stays. These findings have led to the recommendation of early intervention as the best strategy for treating acute cholecystitis.

Keywords: cholecystectomy; complications; early surgery; gall bladder; outcomes.

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Conflict of interest statement

Human subjects: Consent for treatment and open access publication was obtained or waived by all participants in this study. Institutional Review Board of Hayatabad Medical Complex, Peshawar issued approval 2150. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

References

    1. Comparison of clinical safety and outcomes of early versus delayed laparoscopic cholecystectomy for acute cholecystitis: a meta-analysis. Zhou MW, Gu XD, Xiang JB, Chen ZY. Scien World Journ. 2014;2014:274516. - PMC - PubMed
    1. Early versus delayed laparoscopic cholecystectomy for acute cholecystitis: a comparative study. Chhajed R, Dumbre R, Fernandes A, et al. Int Surg J. 2018;5:3381–3385.
    1. Cost utility of early versus delayed laparoscopic cholecystectomy for acute cholecystitis. Johner A, Raymakers A, Wiseman SM. Surg Endosc. 2013;27:256–262. - PubMed
    1. Cost-utility and value-of-information analysis of early versus delayed laparoscopic cholecystectomy for acute cholecystitis. Wilson E, Gurusamy K, Gluud C, Davidson BR. Br J Surg. 2010;97:210–219. - PubMed
    1. Evaluation of early versus delayed laparoscopic cholecystectomy in acute cholecystitis. Agrawal R, Sood KC, Agarwal B. Surg Res Pract. 2015;2015:349801. - PMC - PubMed

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