Laparoscopic Cholecystectomy for Acute Cholecystitis After 72 Hours of Symptoms

Laparoscopic Cholecystectomy for Acute Cholecystitis: is the Rule of 72 Hours Still Actual?

The purpose of this study is to compare the clinical outcomes of early versus delayed laparoscopic cholecystectomies for acute cholecystitis with more than 72 hours of symptoms.

In acute biliary cholecystitis, there was a dogma that patients should be operated within 72 hours of evolution. However, retrospective studies suggested that laparoscopic cholecystectomy even after 72 hours was safe. Moreover, some randomized controlled-trials did not found any differences in term of complications between early and delayed cholecystectomy, however none of these studies did separate patients according to the onset of symptoms. The aim of our present study was to compare the clinical outcomes of immediate versus delayed cholecystectomies for acute cholecystitis with more than 72 hours of symptoms.

Inclusion Criteria:

• proven echographic cholecystitis

Exclusion Criteria:

• pregnancy
• immunosuppression
• severe sepsis
• perforated cholecystitis
• peritonitis
• cholangitis
• acute pancreatitis