American Journal of Biological and Pharmaceutical Research

A COMPARATIVE ANALYSIS OF EARLY VERSUS DELAYED LAPAROSCOPIC CHOLECYSTECTOMY FOR ACUTE CHOLECYSTITIS

Arnab De. J. Bhaumik*, Pratip Sengupta, S. M. Bhattacharya, Sudip Ghosh, Soumen Das

soumendoc.das@gmail.com

Acute cholecystitis, Laparoscopic cholecystectomy, Conversion rate, VAS score.

The aim of this study was to compare the results of laparoscopic cholecystectomy in patients of acute cholecystitis having symptoms for less than five days with those having symptoms for more than five days. 87 patients with diagnosis of acute cholecystitis, admitted to a tertiary care hospital for laparoscopic cholecystectomy were recruited for the study. They were randomly assigned either to early laparoscopic cholecystectomy within five days of presentation of symptoms (n = 43) or to initial conservative treatment followed by delayed laparoscopic cholecystectomy after five days (n = 44). The groups were matched for age, sex, BMI and pre-existing diseases. The pre-anesthetic regimen, anesthesia procedure and laparoscopic technique were uniform. The primary efficacy parameters were measure of conversion rate and post-operative complications in the two groups. Duration of operation, duration of hospital stay, microbial sensitivity pattern of bile were the secondary parameters. 87 patients in all completed the study. There was no statistically significant difference between the groups in regard to conversion rates. (early, 21% versus delayed, 30%, p > 0.05 ). Post-operative pain as scored by VAS did not show significant differences between the groups at any time point. However, significant difference was observed in duration of operation (< 1hr in 86% of early group patients vs 68.1% of delayed group, p < 0.05) and in the duration of post-operative hospital stay (< 3 days in 58.1% of early group patients vs 25% of delayed group, p < 0.05). Statistical significance was seen in requirement of drains between the two groups (early, 11.65% versus delayed, 41%, p < 0.05). There was not much of a difference between the early and the delayed groups in terms of success of laparoscopic cholecystectomy in acute cholecystitis, except for shorter hospital stay, less time of surgery and fewer requirements for drains in the early group. Thus it may be concluded that early laparoscopic cholecystectomy for acute cholecystitis is a safe and feasible offering additional benefit of shorter hospital stay with less operative time.