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Subject Area

Dermatology

Article Type

Original Study

Abstract

Objective The aim was to compare the safety of early (≤72 h) vs late (>72 h to 7 days) laparoscopic cholecystectomy (LC) from symptom onset for acute cholecystitis (AC). Background As LC within 72 h of symptom onset was considered the optimum time, sometimes there was a delay in diagnosis and management. So, we raised the question of safety and feasibility of performing LC for patients with AC who failed to have LC within 72 h of acute attack. Patients and methods This was a prospective randomized comparative study carried out on 120 patients presented with AC at Damanhour Teaching Hospital, El Beheira, Egypt, between September 2017 and April 2019. Patients were randomly allocated into two equal groups assigned to LC: group E: within 72 h of symptom onset, and group L: after 72 h up to 7 days from symptom onset. Results There were no statistically significant differences between both groups regarding demographic data, American Society of Anesthesiologist physical status, history of previous upper abdominal operations, conversion to open cholecystectomy, postoperative complications, and hospital stay. Operative duration and intraoperative blood loss were significantly higher in group L than group E. Conclusion Extending the golden time for LC up to 7 days of acute attack was safe and feasible. It was associated with the same open cholecystectomy conversion rate, postoperative complications rate, and length of hospital stay; however, the operative duration and intraoperative blood loss were significantly increased. We highly recommend a well-trained laparoscopic surgeon to perform the procedure for patients' safety.

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