Early Versus Delayed Laparoscopic Cholecystectomy for Acute Cholecystitis

Early Versus Delayed Laparoscopic Cholecystectomy for Acute Cholecystitis: A Prospective Study Adjusting for Confounding by Indication

The goal of this clinical trial is to learn if performing gallbladder surgery early is as safe and effective as delaying it for people with acute cholecystitis (a sudden gallbladder infection). The main questions it aims to answer are:

• Do participants who have early surgery have a similar rate of complications compared to those who have delayed surgery?
• How does the timing of surgery affect the length of the hospital stay?

Researchers will compare two groups:

1. An early surgery group
2. A delayed surgery group

Participants in the early surgery group had their gallbladder removed within 72 hours of when their symptoms started. Participants in the delayed surgery group were first treated with medications and had their surgery 6-8 weeks later.

Inclusion Criteria:

• Yemeni nationals aged 18-70 years
• A clinical diagnosis of acute cholecystitis confirmed by clinical presentation, laboratory findings, and imaging studies
• Symptom duration of less than 72 hours at presentation
• Fitness for general anesthesia (American Society of Anesthesiologists [ASA] physical status classification I-III)
• Provision of written informed consent

Exclusion Criteria:

• Evidence of choledocholithiasis or acute cholangitis
• Severe comorbidities precluding surgery (ASA class IV-V)
• Coagulopathy (INR >1.5 or platelet count <100,000/μL)
• Pregnancy
• Previous major upper abdominal surgery
• Patient refusal to participate