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RMJ. 2014; 39(2): 199-202


Laproscopic Cholecystectomy for Acute Cholecystitis : Early Vs Delayed

Munawar Jamil, Khurram Niaz, Tariq Hassan Ch, Asghar Ali, Sajid Saeed.

Abstract
Objective: To Compare results and outcome of early to interval laparoscopic cholecystectomy for complications, reasons for convertion ,conversion rate, operation time and hospital stay. So to evaluate the safety and feasibility of laparoscopic cholecystectomy for acute cholecystitis.
Study Design: Prospective observational non-randomised study
Place and Duration of Study : Department of Surgery, Bahawal Victoria Hospital, Bahawalpur from January 2010 to June 2012.
Methodology : All patients presented to surgical department with acute symptomatic gall stones, being candidate for surgery, were included in the study .Standard four port laproscopic cholecystectomy was performed by experienced surgeon. Early or delayed laparoscopic cholecystectomy(LC) decided after councilling, on patient`s will. Early LC was performed within 72 hours and delayed after 6-8 weeks Patients were assessed for operation time, per-operative, post-operative, complications,operation time and hospital stay. Patients were followed up for one week, one month and 3 months after discharge.
Results: Of 103 patients with acute cholecystytis enrolled,51.45% underwent early and 48.54% underwent delayed laproscopic cholecystectomy(LC). Both groups matched in age and gender .Per-operative complications were (7.54%) in early and (10%) in delayed group, resulting in conversion.Post-operative complications were (9.43%) in early and (8%) in delayed group.Colangities, Haematoma and Bile leack was more common in early and Ileus in delayed group.Insignificant difference in Average operation time was noted. Hospital stay was 3.47±1.40 days in early and 6.2±1.36 in dealyed LC group, signigiciantly higher in delayed group.
Conclusion:Complications, reasons for convertion and conversion rate were similar, but hospital stay was statistically significantly reduced in early laproscopic colycystectomy. Early laparoscopic cholecystectomy for acute cholecystitis is safe and feasible, with shorter hospital stay. It should be offered to patients with acute cholecystitis.

Key words: Acute cholecystitis, early laparoscopic cholecystectomy, interval/delayed laparoscopic cholecystectomy.


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