COMPARATIVE STUDY BETWEEN EARLY AND LATE LAPAROSCOPIC CHOLECYSTECTOMY IN TREATMENT OF ACUTE CHOLECYSTITIS IN BUNDELKHAND REGION
DOI:
https://doi.org/10.22159/ajpcr.2024v17i7.51349Keywords:
Early cholecystectomy,, Laparoscopic cholecystectomy, Conversion rate, Complication.Abstract
Objectives: Laparoscopic cholecystectomy is considered the procedure of choice for patients presenting with acute cholecystitis. The following study is an attempt to compare the outcome and operative complications of early versus late laparoscopic cholecystectomy in patients presenting with acute cholecystitis in a tertiary care center in Banda district of bundelkhand region.
Methods: The present study involved a review of case records of 80 patients with the clinical diagnosis of acute cholecystitis, admitted in the surgical wards of a tertiary care center of Banda district during the period from January 2023 to December 2023 who underwent laparoscopic cholecystectomy on an elective basis. Participants were divided into two groups, Group A (early laparoscopic cholecystectomy) and Group B (delayed laparoscopic cholecystectomy) containing 40 patients each. The hospital records of these patients were reviewed and analyzed.
Results: The present study showed statistically significant differences in age distribution and duration of surgery. The average duration of surgery was 42.3±8.97 min in Group “A” and 53.5±9.87 min for Group “B.” Male-to-female ratio was 2:1. The rate of conversion was found to be 2.5% in Group “A” as compared to 10% in Group “B.” Post-operative complications such as wound infection and biliary leakage were more common in Group “B” in comparison of Group “A.”
Conclusion: Early cholecystectomy can be considered a safe and better method of treatment for acute cholecystitis due to its shorter hospital stay, avoidance of readmission to hospital, and decreased overall costs of treatment which is a major economic benefit to both the patient and health care system in comparison of late cholecystectomy.
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References
Watters CR. Basic techniques of laparoscopic cholecystectomy. In: Atlas of Laparoscopic Surgery. 2nd ed. Philadelphia, PA: Current Medicine; 1996. p. 71-7.
Strasberg SM. Clinical practice. Acute calculous cholecystitis. N Engl J Med. 2008;358(26):2804-11. doi: 10.1056/NEJMcp0800929, PMID: 18579815
Takada T, Strasberg SM, Solomkin JS, Pitt HA, Gomi H, Yoshida M, et al. TG13: Updated Tokyo guidelines for the management of acute cholangitis and cholecystitis. J Hepatobiliary Pancreat Sci. 2013;20(1):1-7. doi: 10.1007/s00534-012-0566-y, PMID: 23307006
Overby DW, Apelgren KN, Richardson W, Fanelli R, Society of American Gastrointestinal and Endoscopic Surgeons. SAGES guidelines for the clinical application of laparoscopic biliary tract surgery. Surg Endosc. 2010;24(10):2368-86. doi: 10.1007/s00464-010- 1268-7, PMID: 20706739
Kolla SB, Aggarwal S, Kumar A, Kumar R, Chumber S, Parshad R, et al. Early versus delayed laparoscopic cholecystectomy for acute cholecystitis: A prospective randomized trial. Surg Endosc. 2004;18(9):1323-7. doi: 10.1007/s00464-003-9230-6, PMID: 15803229
Thami G, Kansal R, Singla DK, Agrawal N. Comparative study between early and late laparoscopic cholecystectomy in the treatment of acute cholecystitis. Int J Contemp Med Res. 2022;9(1):A9-12.
Cameron IC, Chadwick C, Phillips J, Johnson AG. Acute cholecystitis- -room for improvement? Ann R Coll Surg Engl. 2002;84(1):10-3. PMID: 11890619
DeCamp PT, Ochsner A, Baffes TG, Bancroft H, Bendel W. Timing in the surgical treatment of acute cholecystitis. Ann Surg. 1952;135(5):734- 50. doi: 10.1097/00000658-195205000-00018, PMID: 14924529
Somasekar K, Shankar PJ, Foster ME, Lewis MH. Costs of waiting for gall bladder surgery. Postgrad Med J. 2002;78(925):668-9. doi: 10.1136/ pmj.78.925.668, PMID: 12496322
Johansson M, Thune A, Blomqvist A, Nelvin L, Lundell L. Management of acute cholecystitis in the laparoscopic era: Results of a prospective, randomized clinical trial. J Gastrointest Surg. 2003;7(5):642-5. doi: 10.1016/s1091-255x(03)00065-9, PMID: 12850677
Verma S, Agarwal PN, Bali RS, Singh R, Talwar N. Early versus delayed laparoscopic cholecystectomy for acute cholecystitis: A prospective randomized trial. ISRN Minim Invasive Surg. 2013;2013:4861071-3. doi: 10.1155/2013/486107
Yadav RP, Adhikary S, Agrawal CS, Bhattarai B, Gupta RK, Ghimire A. A comparative study of early vs. Delayed laparoscopic cholecystectomy in acute cholecystitis. Kathmandu Univ Med J (KUMJ). 2009;7(25):16- 20. doi: 10.3126/kumj.v7i1.1759, PMID: 19483447
Gul R, Dar RA, Sheikh RA, Salroo NA, Matoo AR, Wani SH. Comparison of early and delayed laparoscopic cholecystectomy for acute cholecystitis: Experience from a single center. N Am J Med Sci. 2013;5(7):414-8. doi: 10.4103/1947-2714.115783, PMID: 24020050
Saber A, Hokkam EN. Operative outcome and patient satisfaction in early and delayed laparoscopic cholecystectomy for acute cholecystitis. Minim Invasive Surg. 2014;2014:162643. doi: 10.1155/2014/162643, PMID: 25197568
Gurusamy KS, Junnarkar S, Farouk M, Davidson BR. Cholecystectomy for suspected gallbladder dyskinesia. Cochrane Database Syst Rev. 2009;1(1):CD007086. doi: 10.1002/14651858.CD007086.pub2, PMID: 19160318
Papi C, Catarci M, D’Ambrosio L, Gili L, Koch M, Grassi GB, et al. Timing of cholecystectomy for acute calculous cholecystitis: A meta-analysis. Am J Gastroenterol. 2004;99(1):147-55. doi: 10.1046/j.1572- 0241.2003.04002.x, PMID: 14687156
Misra MC, Khanna S, Khosla A, Berry M, Kapur BM. Emergency versus elective cholecystectomy in acute cholecystitis. Jpn J Surg. 1988;18(4):384-9. doi: 10.1007/BF02471461, PMID: 3050215
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