Early Versus Delayed Laparoscopic Cholecystectomy in Cases of Acute Cholecystitis

Acute cholecystitis (AC) is considered a significant disease all over the world. Cholecystectomy represents the only definitive management strategy for symptomatic gallstone disease. Studying the efficacy and feasibility of early laparoscopic cholecystectomy in cases of acute cholecystitis in comparison with delayed laparoscopic cholecystectomy regarding procedure safety, operative time, perioperative complications, post-operative pain, total length of hospital stay, and loss of active days of work. Prospective and comparative study of early versus delayed laparoscopic cholecystectomy in 50 patients suffering from acute cholecystitis. This study will be conducted in the Department of Surgery at Al-Zahraa University Hospital. Group A: Those who come within 72 hours of the attack will undergo an early laparoscopic cholecystectomy. Group B: Those who come after 72 hours of attack will be admitted and given conservative management, and then they will do a late laparoscopic cholecystectomy after 4–8 weeks. Patients in both groups had comparable comorbidities, BMI, and histories of previous surgeries with statistically insignificant differences (p > 0.05). Group B had a significantly longer duration of pain (5.4±1.2 weeks) than group A (38.7±15 hours) (p<0.001). Also, 4 patients (16%) had a recurrent attack. Murphy's sign and palpable gall bladder showed insignificant differences in both groups. All preoperative laboratory findings showed insignificant differences between the study groups as p>0.05. The results of the ultrasound findings in the study groups revealed that a thick gall bladder wall was the most common finding in both groups, followed by pricholecystic fluid collection then impacted stone. Early laparoscopic cholecystectomy (ELC) is effective, safe, and feasible. It had no increase in operative time or perioperative complications. In terms of a shorter overall hospital stay and fewer days missed from work; it is preferable to a delayed cholecystectomy. While patients wait for definitive surgical intervention, early laparoscopic cholecystectomy prevents the risk of repeated attacks or the emergence of other biliary problems.