Comparison of Early Versus Delayed Cholecystectomy in Acute Cholecystitis: A Prospective Study in a Tertiary Care Hospital
Keywords:
Acute Cholecystitis, Early Cholecystectomy, Delayed Cholecystectomy, Laparoscopic CholecystectomyAbstract
Background: The optimal timing of cholecystectomy for acute cholecystitis remains debated. This study aimed to compare outcomes of early versus delayed cholecystectomy in an Indian tertiary care setting.
Methods: This prospective study included 150 patients with acute cholecystitis, allocated to early (within 72 hours of admission, n=75) or delayed (after 6-8 weeks, n=75) cholecystectomy groups. The primary outcome was the total length of hospital stay. Secondary outcomes included operative time, conversion rates, complications, and cost-effectiveness.
Results: Early cholecystectomy was associated with longer operative times (78.5 ± 22.3 vs. 65.2 ± 18.7 minutes, p = 0.001) but significantly shorter total hospital stays (median, 3 vs. 7 days, p < 0.001). Conversion rates were higher in the early group but not statistically significant (8% vs 2.7%, p=0.145). Complication rates were similar between groups. Quality of life scores at 30 days post-surgery trended higher in the early group but were not statistically significant.
Conclusion: Early cholecystectomy for acute cholecystitis is safe, effective, and cost-efficient in the Indian healthcare context. It results in shorter hospital stays and lower readmission rates without increasing complications. These findings support early cholecystectomy as the preferred approach for suitable patients with acute cholecystitis, potentially improving patient outcomes and healthcare resource utilization.
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