COMPARISON OF OUTCOMES OF EARLY VERSUS DELAYED LAPAROSCOPIC CHOLECYSTECTOMY AFTER ACUTE CHOLECYSTITIS

Abstract

Background: Acute cholecystitis is a frequent surgical emergency resulting from gallstone obstruction of the cystic duct. Laparoscopic cholecystectomy is the preferred treatment; however, the ideal timing of surgery—early versus delayed—remains controversial. Early intervention may reduce hospital stay and recurrence, while delayed surgery is thought to lower operative difficulty and complications.

Objective: To compare the surgical outcomes of early versus delayed laparoscopic cholecystectomy after acute cholecystitis.

Study Design and Setting: This quasi-experimental study was conducted in the Department of General Surgery, Shaik Zayed Hospital Lahore from April 2024 to April 2025.

Methodology: A total of 150 patients diagnosed with acute calculous cholecystitis were included through non-probability consecutive sampling and divided into two equal groups. Group A underwent early laparoscopic cholecystectomy within 72 hours of hospital admission, while Group B underwent delayed surgery after 6–8 weeks of conservative management. Data were analyzed using SPSS version 25.0. The main outcome variables were operative time, postoperative complications, and total hospital stay. Mean and standard deviation were calculated for quantitative variables, while frequencies and percentages were computed for categorical variables. Chi-square and t-tests were applied, with p < 0.05 considered significant.

Results: The mean operative time was significantly shorter in the early group (58.6 ± 10.2 minutes) compared to the delayed group (72.8 ± 11.5 minutes; p < 0.001). Postoperative complications occurred in 10.7% and 14.7% of patients in the early and delayed groups, respectively (p = 0.47). Mean hospital stay was significantly reduced in the early group (3.2 ± 0.8 days vs. 5.9 ± 1.1 days; p < 0.001).

Conclusion: Early laparoscopic cholecystectomy after acute cholecystitis is safe, effective, and associated with shorter operative time and hospital stay compared to delayed surgery.