A Comparative Study of Early Vs Delayed Laparoscopic Cholecystectomy

Early Vs Delayed Laparoscopic Cholecystectomy

Abstract

Background: To compare early and delayed laparoscopic cholecystectomy. Subjects & Methods: Eighty four patients age ranged 20-60 years of both genders with complaint of acute cholecystitis reported to the Department of General surgery at Pt. Jawahar Lal Nehru Government Medical College and Hospital Chamba from April 2019 to March 2020 were divided into 2 groups of 42 each based on lottery system. Group A was early laparoscopic cholecystectomy and group B was delayed or late laparoscopic cholecystectomy. Parameters such as operative time, conversion to open cholecystectomy, Adhesions, biliary duct injury, wound infection and hospital stay was recorded. Results: Common clinical features were fever seen in 20 in group A and 23 in group B, pain abdomen in all patients in both groups, vomiting in 18 in group A and 12 in group B, jaundice in 3 in group A and 1 in group B and 23 in group A and 25 in group B were febrile. A significant difference was found between both groups. Multiple GB calculi was seen in 34 in group A and 36 in group B, pericystic fluid collection 22 in group A and 28 in group B, GB wall thickening 7 in both groups, conversion to open surgery was seen in 8 in group A and 12 in group B, adhesions 5 and 11, bleeding in 4 and 16, GB perforation in 2 and 3, bile duct injury in 1 and 3 in group A and B respectively. The mean duration of surgery in group A patients was 78.2 minutes and in group B was 118.2 minutes and hospital stay was 3.1 days in group A and 6.4 days in group B. A significant difference was observed (P< 0.05). Post op wound infection was seen in 3 in group A and 8 in group B, post op bile leak in 2 in group A and 5 in group B and post op jaundice in 1 and 4 in group A and B respectively. A significant difference was found between both groups (P< 0.05). Conclusion: Early cholecystectomy group had better results in terms of shorter hospital stay, less conversion to open surgery, less post- operative complications and duration of surgery.