Niazi et al Int. j. med. appl. health. Vol. 2, No. 2, 2014 67 LAPAROSCOPIC CHOLECYSTECTOMY IN THE PRESENCE OF ACUTE CALCULUS CHOLECYSTITIS VS DELAYED- ELECTIVE CHOLECYSTECTOMY; OUR EXPERIENCE AT DISTRICT TEACHING HOSPITAL SARGODHA. M. Ashraf Khan Niazi 1 ,Nasir Mahmood Virk 1* , Khalid Mahmood 1 , Hafiz Zafar Nazir 2 1 surgery Department, Sargodha Medical College, University of Sargodha, Pakistan 2 Statistics Department, University of Sargodha, Pakistan * Corresponding Author e-mail; drnasirmahmoodvirk@hotmail.com ABSTRAC This prospective study was carried out to evaluate feasibility and effectiveness oflaparoscopic cholecystectomyin acute calculuscholecystitis. In this study 30 patients were includedwith a diagnosis of acute calculuscholecystitis, who underwent upon early laparoscopic cholecystectomy within 96 hours of admission. The patients of acute cholecystitis, group 1 (early) was compared with a group 2 (delayed-elective),underwent delayed laparoscopic cholecystectomy after an initial period of conservative treatment. The results indicated that there was no significant difference statistically in the conversion to open cholecystectomy (3 early versus 2 delayed- elective),duration of postoperative hospital stay(2.96 days early versus 1.94 days delayed) and postoperative analgesia requirements.However, the operative time was longer in the early group (101.83 minutes versus 52.16 minutes delayed). The spillage of the gallstones was observed (4 early versus 3 delayed-elective).Postoperatively bile leak was observed in one patient of early group due to minor injury of common bile duct. Wound infection of port site was 3 in early versus 2 in delayed. The conclusion was that early laparoscopic cholecystectomy for acute calculus cholecystitis is a feasible and safe technique/operation. To decrease the risk of conversion and operative time, it is recommended to perform the cholecystectomy during the first 96 hrs after the onset of symptoms. Key words; laparoscopic cholecystectomy, acute calculus cholecystitis, operative time INTRODUCTION Acute calculuscholecystitis, previous abdominal surgery and obesity was once considered contraindicated for laparoscopic cholecystectomy, however because of extensive experience with laproscopic procedures, patience, careful dissection and identification of vital structures, these factors are currently not considered as contraindications. Several randomized and nonrandomized reportshave documented that laparoscopic cholecystectomy for acute calculuscholecystitis is performed with success.In experienced hands, this is the most commonly performed abdominal operationin the world(NIH,Organization, 1992).The traditional earlytreatment of acute calculus cholecystitiscomprises of nil per oral, fluids resuscitation, replacement of electrolytes loss, pain relief, and intravenous broad spectrum antibiotics. Following this treatment, patients were called for laparoscopic cholecystectomy after a period of 6-8 weeks. Laparoscopic cholecystectomy is avoided for acute calculus cholecystitis due to concerns about the potential hazards of complications including bile leakage, bowel injury and bleeding. (Cuschieri et al 1991).Initial studies however have shown that early laparoscopic cholecystectomy can be done during acute calculus cholecystitis (Lali et al 1998, Teach et al 2007,Johansson et al 2002). Since most of the surgeons prefer to delay surgery during the acute phase.We conducted a prospective study for comparisonand evaluation of the effects of early and delayed-elective laparoscopic cholecystectomy in the treatment of acute calculuscholecystitis. MAETERIALS AND METHODS The present study included 30 patients who underwent early laparoscopic cholecystectomy for acute calculus cholecystitis at the department of Surgery,Sargodha Medical Collegeatits associated DHQ teaching hospital in Sargodhawhere many modern facilities for surgery were lacking. The period included was from July 2011 to June 2014.The