Abstract

Background: Acute cholecystitis is a pathology of inflammatory origin, usually associated with cholelithiasis, with a high incidence in the environment. The treatment of acute cholecystitis involves an important socioeconomic impact. There are two surgical therapeutic options: early laparoscopic cholecystectomy (ELC) during the same admission or delayed laparoscopic cholecystectomy (DLC) during a later admission after conservative treatment. Aim and Objective Aim: To evaluate and compare the effectiveness between the early laparoscopic cholecystectomy vs delayed laparoscopic cholecystectomy in the treatment of acute cholecystitis. Objectives: • To compare the timing of surgery, number of days of antibiotic coverage. • To compare the number of days of hospital stay. • To compare the intraoperative, post-operative complications, conversion to open cholecystectomy and follow up. • To compare the overall mortality and morbidity Patients and Methods: It is a prospective study taking 65 patients were randomly selected to exclude any bias satisfying inclusion and exclusion criteria for the study, were admitted to the Dept. of General Surgery, MKCG Medical College and Hospital, Berhampur, Ganjam, Odisha, During the period from March 2023 to February 2025. Results: In the study out of 65 patients, 33 patients underwent ELC and 32 patients underwent DLC, who were selected randomly. The mean duration of timing of surgery in ELC and DLC were 47.36 minutes and 65.75 minutes respectively. The mean duration of antibiotic coverage in ELC and DLC was found to be 3.58 days and 5.50 days respectively. The complications like adhesions, bleeding, edematous gallbladder, bile leak, gallbladder perforations were noted in both the groups. But these were comparatively lower in ELC than in DLC. On comparing the mean duration of hospital stay in ELC and DLC it was found to be 4.67 days and 6.50 days respectively. In the group of ELC the follow up period was almost uneventful. But in the DLC group there were readmissions recurrently and also complications like gallstone induced pancreatitis was seen. Hence, the follow up period revealed that ELC is better than DLC. Conclusion: From the present study, we conclude that as compared to patients who underwent DLC, the parameters like mean timing of surgery, mean duration of antibiotic coverage, number of complications, mean duration of hospital stay, complaints in the follow up period are comparatively less in patients who underwent ELC. Hence, in patients of acute calculous cholecystitis, ELC is safe and preferable method of choice as compared to DLC, finally leading to reduction in the cost of treatment for the patient.

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