Post operative complications in Early versus interval laparoscopic cholecystectomy for acute cholecystitis: A one year Eastern Indian experience

Abstract

Background: Laparoscopic cholecystectomy is the gold standard method of treatment for acute cholecystitis. Controversy remains regarding its timing. Interval cholecystectomy after 4 to 6 weeks of resolution of acute inflammation was the standard of care but recent trend towards early cholecystectomy within 72 hours of symptom onset. Comparative study between these two approaches is limited from Eastern India private hospitals. The objective of the study is to compare the post operative complications of these two approaches in a tertiary care Hospital in Eastern India.

Methods: A prospective observational study was conducted for one year duration(01.02.2019 to 31.01.2020) at the Department of Surgery, Peerless Hospital, Kolkata with 50 patients divided into 2 groups of surgical intervention (based on admission in even and odd days of week ). Post operative complications were noted at first week and six week follow up. The statistical analysis was performed using SPSS software with a p-value < 0.05 was considered to be statistically significant.

Results:

2 patients had epigastric pain at port site in both surgical intervention groups. No patients in either group had post operative jaundice. In early group 4 patients (16%) had increased ESR and 3 patients (12%) had increased CRP during the 1^st follow up visit which became normal in the next follow up. No patients in either group suffered from continuous drainage of bile, blood, wound infection & mortality

Conclusion: Our study clearly depicts no difference in post operative complications between early and interval cholcyestetomy. Early laparoscopic cholecystectomy within 72 hours of symptom onset is the preferred and safe method for treating acute cholecystitis than interval laparoscopic cholecystectomy in Indian patients.