International Surgery Journal | April 2020 | Vol 7 | Issue 4 Page 1212 International Surgery Journal Rather ZM et al. Int Surg J. 2020 Apr;7(4):1212-1217 http://www.ijsurgery.com pISSN 2349-3305 | eISSN 2349-2902 Original Research Article Outcome of early laparoscopic cholecystectomy versus delayed laparoscopic cholecystectomy for patients with acute cholecystitis Zahid Mohd Rather 1 , Nighat Ara Majid 2 *, Mohd Nazrull Islam 1 , Raja Waseem Mohd 3 INTRODUCTION Acute cholecystitis is inflammation of gall bladder, usually associated with cholelithiasis, with a high incidence in our environment. Laparoscopic cholecystectomy (LC) has been the procedure of choice for symptomatic gall bladder disease. 1 Laparoscopic cholecystectomy can be done as early laparoscopic cholecystectomy (ELC) or delayed laparoscopic cholecystectomy (DLC) after conservative treatment. However, the definition of “early” varies amongst the guidelines,the British Society of Gastroenterology recommend cholecystectomy within the same hospital admission or up to 2 weeks after discharge. 2 The American Gastroenterological Association guidelines suggest that cholecystectomy should be performed as soon as possible and in no case beyond 2-4 weeks after discharge, whereas the American College of ABSTRACT Background: This prospective randomized study was undertaken to to assess the outcomes of early versus delayed cholecystectomy for patient’s acute cholecystitis. Methods: 70 patients with acute cholecystitis were prospectively randomized to either an early laparoscopic cholecystectomy (n=35) or a delayed laparoscopic cholecystectomy group (n=35). The mean operative time, conversion rate, total hospital stay, intra-operative and post-operative complications, average hospital cost were evaluated between the two groups. Results: A total of 70 patients were enrolled, 35 patients in each group. There was no significant difference in the conversion rates (early, 8.57% vs delayed, 5.71%) and postoperative complications (early, 25% vs delayed, 20%). At the cost of an increased operating time (early, 81 minutes vs delayed, 78 minutes) and blood loss (early, 180.33ml vs delayed, 108.00 ml), early laparoscopic cholecytectomy significantly shortened the total hospital stay (early, 1.5 days vs. delayed, 7.95 days) and average hospital cost (early 9240 INR vs delayed, 12251 INR). Conclusions: The safety and efficacy of early and delayed laparoscopic cholecystectomy for acute cholecystitis were comparable in terms of morality, morbidity and conversion rate. However early laparoscopic cholecystectomy allows significantly shorter total hospital stay and reduction in days away from work at the cost of longer operating time and blood loss and offers definitive treatment at initial admission. Moreover it avoids repeated admissions for recurrent symptoms has both medical as well as socioeconomic benefits and should be the preferred approach for patients managed by surgeons with adequate experience in laparoscopic cholecystectomy. Keywords: Acute chholecystitis, Delayed laparoscopic cholecystectomy, Early laparoscopic cholecystectomy 1 Department General and Minimal Access Surgery, Government Medical College and Associated Hospital, Srinagar, India 2 Department of Obstetrics and Gynaecology, Government College Srinagar, Jammu and Kashmir, India 3 Department of Radiology and Imaging, Government Medical College and Associated Hospital, Srinagar, India Received: 17 January 2020 Accepted: 04 March 2020 *Correspondence: Dr. Zahid Mohd Rather, E-mail: drzahidmrather@yahoo.com Copyright: © the author(s), publisher and licensee Medip Academy. This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. DOI: http://dx.doi.org/10.18203/2349-2902.isj20201399