European Journal of Cardiovascular Medicine

Gallstone disease is a common gastrointestinal disorder worldwide, with acute cholecystitis being one of its frequent complications. Acute cholecystitis results from obstruction of the cystic duct, usually by gallstones, leading to inflammation of the gallbladder. Patients typically present with right upper quadrant pain, fever, nausea, and leukocytosis.

Laparoscopic cholecystectomy has become the gold standard treatment for symptomatic gallstone disease due to its minimal invasiveness, shorter hospital stay, and faster recovery. However, the timing of surgery in acute cholecystitis remains controversial.

Traditionally, delayed laparoscopic cholecystectomy was recommended after initial conservative management to allow inflammation to subside. However, advances in laparoscopic techniques and surgical expertise have encouraged early surgical intervention within the first 72 hours of symptom onset.

Early surgery may reduce recurrent attacks, hospital admissions, and overall treatment cost, whereas delayed surgery allows inflammation to resolve but may increase the risk of recurrent symptoms and additional hospitalizations.

Therefore, this study aims to compare the clinical outcomes of early versus delayed laparoscopic cholecystectomy in patients with acute cholecystitis.

MATERIALS AND METHODS This is a Prospective comparative study was conducted in the Department of General Surgery in a tertiary care teaching hospital. Study Duration 12 months. Sample Size 100 patients diagnosed with acute cholecystitis. Inclusion Criteria • Patients aged 18–70 years • Diagnosed with acute calculous cholecystitis based on clinical, laboratory, and ultrasonographic findings • Patients fit for laparoscopic surgery Exclusion Criteria • Patients with gallbladder perforation or empyema • Severe comorbid illness • Previous upper abdominal surgery • Pregnancy Study Groups Group A (Early LC): • 50 patients underwent laparoscopic cholecystectomy within 72 hours of symptom onset. Group B (Delayed LC): • 50 patients initially received conservative treatment followed by laparoscopic cholecystectomy after 6–8 weeks. Data Collection The following parameters were recorded: • Age and gender • Operative time • Conversion to open surgery • Intraoperative complications • Postoperative complications • Duration of hospital stay Statistical Analysis Data were analyzed using statistical software. Results were expressed as mean ± standard deviation for continuous variables and percentages for categorical variables.

Table 1: Demographic Characteristics

Table 2: Operative Findings

Table 3: Postoperative Complications

Table 4: Hospital Stay

Table 5: Overall Outcomes

The management of acute cholecystitis has evolved significantly with the advancement of laparoscopic surgery. Early laparoscopic cholecystectomy has gained popularity due to its potential benefits, including reduced hospital stay and prevention of recurrent symptoms.

In the present study, the mean age distribution and gender ratio were similar in both groups, which is consistent with other studies showing female predominance in gallstone disease.

The operative time in the early surgery group was slightly longer due to inflammatory changes and adhesions around the gallbladder. Similar findings were reported by several previous studies.

The conversion rate to open surgery was slightly higher in the early group but not statistically significant. This may be attributed to difficulty in dissection due to acute inflammation.

Postoperative complications were comparable between the two groups, indicating that early surgery does not significantly increase surgical risk.

One of the most significant findings of the study was the reduced total hospital stay in the early surgery group. Patients undergoing delayed surgery required two separate hospital admissions, which increased overall hospitalization time and healthcare costs.

Furthermore, some patients in the delayed group experienced recurrent symptoms during the waiting period, necessitating additional medical management.

These findings support the growing body of evidence favoring early laparoscopic cholecystectomy for acute cholecystitis.

Early laparoscopic cholecystectomy within 72 hours of symptom onset is a safe and effective treatment for acute cholecystitis. It offers the advantages of reduced total hospital stay and prevention of recurrent gallbladder attacks without significantly increasing operative complications. Therefore, early surgical intervention should be considered the preferred management strategy in suitable patients.

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