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ORIGINAL ARTICLE
Year : 2020  |  Volume : 26  |  Issue : 2  |  Page : 197-200

Does timing of cholecystectomy in acute cholecystitis affect morbidity


1 Department of General Surgery, Malabar Institute of Medical Sciences Ltd., Kozhikode, Kerala, India
2 Department of Pediatric Surgery, NIKY Hospital, Gandhinagar, Gujarat, India
3 Department of Surgical Gastroenterology, Malabar Institute of Medical Sciences, Kozhikode, Kerala, India
4 Department of General Surgery, Malabar Institute of Medical Sciences, Kozhikode, Kerala, India

Correspondence Address:
Dr. Jinto Augustine Thomas
Department of General Surgery, Malabar Institute of Medical Sciences Ltd., Mini Bypass Road, Govindapuram P. O., Kozhikode - 673 016, Kerala
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ksj.ksj_8_20

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Background: Laparoscopic cholecystectomy (LC) is the accepted treatment for acute cholecystitis (AC), presenting in the first 72 h. Delayed surgery after 6 weeks is the accepted norm in late presentations. Many studies have been done to find the ideal time for surgery in AC and assess complications of surgery in AC. LC after the initial 72 h of onset of symptoms has been associated with increased incidence of conversion to open surgery and also complications. The main was the technical difficulty of dealing with the inflammatory changes, when it becomes denser and fibrotic, thereby increasing chances of biliary and adjacent bowel injuries. Aims and Objective: To determine the relation between timing of surgery and the postoperative outcomes, and to determine the appropriate timing of surgical intervention in acute cholecystitis. Materials and Methods: We conducted a prospective cohort study of 2-year duration. One hundred patients who were diagnosed to have AC based on the clinical and the radiological features were divided into two groups based on the onset of their symptoms and were offered LC at the index admission. Results: Group A included 61 patients within 3 days of starting of symptoms and 42 days after the initial symptoms, and Group B had 39 presenting between 4th day and 41st day of symptoms. No statistical difference was seen between the groups regarding the duration of operation, need for conversion to open procedure and post operative complications. The length of hospital stay was longer in Group B, thus increasing expenditure (P = 0.015). Long term follow up showed no difference in recovery in both the groups. Conclusion: we conclude that LC at index admission is safe and the morbidity of LC remains the same irrespective of the timing of presentation.


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