The timing of surgery for cholecystitis: a review of 202 consecutive patients at a large municipal hospital

Background: Traditionally, cholecystectomy for cholecystitis is performed within 3 days of the onset of symptoms or after 5 weeks, allowing for resolution of the inflammatory response. This study reviewed the outcomes of cholecystectomy performed for patients with gallstone disease in the acute (n = 45), intermediate (n = 55), and delayed (n = 102) periods after the onset of symptoms. Methods: The medical records of 202 patients who underwent laparoscopic cholecystectomy at a large municipal hospital were reviewed retrospectively. The primary outcomes studied were length of hospital stay, conversion to open cholecystectomy, and complications. Results: There was no significant difference in the conversion rate (acute [ 18%] vs intermediate [20%] vs delayed [11%]) or complication rate (acute. [16%] vs intermediate [9%] vs delayed [7%]) among the 3 groups. The delayed group had a significantly shorter length of hospital stay than the intermediate or acute group (3.1 +/- 3.8 vs 4.3 +/- 3.8 vs 1.7 +/- 2.1, respectively, P < .001). Conclusions: Patients who present with acute symptoms of cholecystitis should undergo surgery during the same admission, regardless of the duration of symptoms. (c) 2008 Elsevier Inc. All rights reserved.