OUTCOME OF EARLY VERSUS DELAYED LAPAROSCOPIC CHOLECYSTECTOMY IN ACUTE CHOLECYSTITIS AT TERTIARY CARE CENTRE, KARACHI
Main Article Content
Keywords
Gallstone disease, Laparoscopic cholecystectomy, Acute cholecystitis, Operative time, Hospital stay duration, Bile leak.
Abstract
Introduction:
Gallstone disease is common across the world, with varied frequency in various locations. The conventional therapy for symptomatic cholelithiasis is laparoscopic cholecystectomy (LC), however the scheduling of operation is still controversial. Early laparoscopic cholecystectomy (ELC) yields better clinical results than delayed laparoscopic cholecystectomy (DLC) for acute cholecystitis. Conversion to open cholecystectomy during LC is a significant consequence, and patients with comorbidities, advanced age, prior abdominal surgery, and low albumin levels are at higher risk. Studies show that ELC is safe, reduces hospital stays, and lowers costs compared to DLC.
Aims & Objective:
The purpose of this study was to compare outcomes like bile leak, mean operation time, hospital stay duration, and conversion between patients with acute cholecystitis who underwent early versus delayed laparoscopic cholecystectomy.
Methods:
An observational study was conducted on surgical ward two at Karachi, Pakistan's Jinnah Postgraduate Medical Centre (JPMC) between October 2020 and October 2022. Patients undergoing laparoscopic cholecystectomy for acute cholecystitis were considered for the study. Patients were split into two groups: Group A underwent surgery within seven days of the acute incident, while Group B waited 6-8 weeks after the acute incident to have surgery. Operative duration, hospital stay, bile leak, and rate of conversion were all recorded for both groups. To examine the information, we used SPSS 28.
Results:
The study included patients with a mean age of 42.15, ranging from 18 to 70. In Group A, 16.3% were men, 83.3% were women, while in Group B, 9.5% were men, and 90.5% were women. The mean operative duration in Group A was 98.42 ± 46.25 minutes; the mean hospital duration was 2.47 ± 1.08 days; conversion occurred in 4 (9.5%) patients, and bile leak occurred in 11.9% of patients. In Group B, the mean operative time was 73.28 ± 27.81 minutes, the mean hospital stay was 2.45 ± 1.06 days, and bile leak occurred in 1(2.4%) patient.
Conclusion:
Group B had significantly shorter mean surgical durations, lower rates of bile leakage, and lower rates of conversion to open cholecystectomy than Group A, despite there being no statistically significant difference in the length of hospital stays between the two groups.
References
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Dr. Hira Moosa
Consultant General Surgeon, Surgical Unit IV, Dr. Ruth K. M. Pfau Civil Hospital, Karachi. Affiliated with Dow University of Health Sciences, Karachi.
Dr. Syed Baqir Rizvi
Assistant Professor of Surgery, Dr. Ziauddin Hospital and Postgraduate Institute, Sukkur Campus.
Dr. Aman Khan
Consultant General Surgeon, Sui Field Hospital, Sui.
Dr. Shabina Jaffar
Assistant Professor, Surgical Unit II, Jinnah Postgraduate Medical Centre (JPMC), Karachi. Affiliated with: Baqai Medical University.
Dr. Nargis Shaikh
Consultant General Surgeon, Surgical Unit IV, Dr. Ruth K. M. Pfau Civil Hospital, Karachi. Affiliated with Dow University of Health Sciences, Karachi.
Dr. Anum Iftikhar
Assistant Professor, Surgical Unit I, Jinnah Postgraduate Medical Centre (JPMC), Karachi.