RANDOMIZED TRIAL OF EARLY VERSUS DELAYED LAPAROSCOPIC CHOLECYSTECTOMYFOR ACUTE CHOLECYSTITIS

Background The aim of this prospective randomized study was to define the optimum management between early and delayed laparoscopic cholecys tectomy for patients with acute cholecystitis. Methods Patients were r andomized to receive either early laparoscopic cholecystectomy within 24 h of randomization or initial conservative treatment followed by de layed laparoscopic cholecystectomy 6-8 weeks later. Results There were 53 patients in the early group and 51 in the delayed group. There was no significant difference in conversion rate (early 21 per cent versu s delayed 24 per cent), postoperative analgesic requirement (1 versus 2 doses) and postoperative complications. However, the early group had significantly longer operating time (122.8 versus 106.6 min, P = 0.04 ) and shorter total hospital stay (76 versus 11.6 days, P < 0.001). Co nclusion Early laparoscopic cholecystectomy is safe and feasible for a cute cholecystitis with the additional benefit of shorter total hospit al stay. Apart from a shorter operating time, treating patients with d elayed laparoscopic cholecystectomy does not offer additional benefit.