Is it Safe to do Laparoscopic Cholecystectomy for Acute Cholecystitis up to Seven Days?

Is it Safe to do Laparoscopic Cholecystectomy for Acute Cholecystitis up to Seven Days? A Randomized Clinical Trial

Objectives: To compare the safety of early (≤72h) versus late (>72h-7days) laparoscopic cholecystectomy (LC) from symptom onset for acute cholecystitis (AC).

Background: As LC within 72h of symptom onset was considered the optimum time, sometimes there was a delay in diagnosis and management. So, we raised the question of safety and feasibility of performing LC to patients with AC who failed to have LC within 72h of acute attack.

Patients and Methods: This was a prospective, randomized, double-blind, clinical trial; carried out on 120 patients presented with AC between September 2017 and April 2019. Patients were randomly allocated into two equal groups assigned to LC; group E: within 72h of symptom onset, and group L: after 72h up to seven days from symptom onset.

Inclusion Criteria:

• Patients with AC within seven days from symptom onset
• American Society of Anesthesiologist (ASA) physical status ≤ II
• Age from 21 to 60 years

Exclusion Criteria:

• Patients with ASA physical status > II
• Age < 21 years or > 60 years
• Child classification B or C
• Choledocholithiasis
• Acute pancreatitis
• Severe sepsis
• Gallbladder perforation
• Pregnant women