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Laparoscopic Cholecystectomy for Acute Cholecystitis: Is the Surgery Still Safe beyond the 7-Day Barrier?

  • Original Article
  • Published:
Journal of Gastrointestinal Surgery

A Correction to this article was published on 25 November 2020

This article has been updated

Abstract

Background

The optimal timing for early laparoscopic cholecystectomy (ELC) in patients with acute calculous cholecystitis (ACC) is still controversial. The aim of this study was to assess the outcomes of ELC in patients with delayed presentation.

Methods

Retrospective analysis of 381 patients who underwent ELC for ACC between January 2010 and September 2018. Included patients were classified into two groups according to the timing of surgery from the onset of symptoms: group 1 (G1) within the first 7 days and group 2 (G2) beyond 7 days.

Results

There were no significant differences regarding conversion rate (G1 8.6% vs. G2 11.8%; p = 0.527), operative time (G1 100 min [75–120] vs. G2 120 min [71–150]; p = 0.060), bile duct injuries (G1 0.3% vs. G2 0%; p = 1), major postoperative complications (G1 11% vs. G2 5.9%; p = 0.557), reoperation rates (G1 1.4% vs. G2 0%; p = 1), length of stay (G1 4 days [3–7] vs. G2 5 days [3–7]; p = 0.539), readmissions (G1 3.7% vs. G2 5.9%; p = 0.633) and costs (G1 6035 € [3693–8330] vs. G2 7243 € [4921–11,336]; p = 0.395).

Conclusion

ELC may be considered for patients with ACC who can tolerate surgery with more than 1 week of symptom duration.

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Change history

  • 25 November 2020

    This is a single-institution retrospective observational study of patients who underwent ELC for ACC.

Abbreviations

ACC:

acute calculous cholecystitis

ASA:

American Society of Anesthesiologists

CDC:

Centers for Disease Control

DLC:

delayed laparoscopic cholecystectomy

ELC:

early laparoscopic cholecystectomy

G1:

group 1

G2:

group 2

LC:

laparoscopic cholecystectomy

LOS:

length of stay

RCT:

randomised controlled trial

TG13:

Tokyo Guidelines 2013

TG18:

Tokyo Guidelines 2018

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Authors and Affiliations

  1. Department of General and Digestive Surgery, Hospital Universitario de la Princesa, Diego de León Street, 62–4th Floor, 28006, Madrid, Spain

    Ismael Mora-Guzmán, Marcello Di Martino, Alvaro Gancedo Quintana & Elena Martin-Perez

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  1. Ismael Mora-Guzmán
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  2. Marcello Di Martino
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  3. Alvaro Gancedo Quintana
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  4. Elena Martin-Perez
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We hereby certify that all listed co-authors were integrally involved in the formation of this manuscript via study conception/design and/or data acquisition and analysis/interpretation. Furthermore, all authors made significant contributions to the drafting or critical revisions of the manuscript, and all authors gave final approval prior to submission for publication.

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Correspondence to Marcello Di Martino.

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Presented as a podium oral communication at the 32nd National Congress of Surgery, Spanish Surgical Association, November 12–15, 2018, Madrid, Spain.

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Mora-Guzmán, I., Di Martino, M., Gancedo Quintana, A. et al. Laparoscopic Cholecystectomy for Acute Cholecystitis: Is the Surgery Still Safe beyond the 7-Day Barrier?. J Gastrointest Surg 24, 1827–1832 (2020). https://doi.org/10.1007/s11605-019-04335-5

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