ASSISTMENT OF EARLY VS DELAYED LAPAROSCOPIC CHOLECYSTECTOMY IN ACUTE GALLSTONE DISEASE
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Keywords
Early Laparoscopic Cholecystectomy; Delayed Laparoscopic Cholecystectomy; Gallstone Disease; Acute Cholecystitis; Gallstone Pancreatitis; Postoperative Outcomes; Recurrence; Healthcare Utilization
Abstract
Background: Deciding when to perform laparoscopic cholecystectomy for acute gallstone disease is still an important clinical issue. This study set out to compare the outcomes of Early Laparoscopic Cholecystectomy (ELC) and Delayed Laparoscopic Cholecystectomy (DLC).
Methods: This retrospective observational study took place at District Headquarters (DHQ) Hospital from June 5 to September 1, 2023, and included 100 patients with acute gallstone-related disease. ELC was surgery within 72 hours of diagnosis, while DLC was done at least 6 weeks after the acute episode. The study looked at complication rates, hospital stay, recovery, gallstone recurrence, readmissions, and extra interventions. Independent t-tests and chi-square tests were used for analysis, with p<0.05 as the threshold for significance.
Results: The two groups had similar demographics (average age about 48 years, female-to-male ratio 1.15:1). ELC showed clear long-term benefits, such as a lower rate of gallstone recurrence (10% vs 17%; p<0.05), fewer readmissions per patient (1.3 vs 1.8), and less need for follow-up imaging (40% vs 52%). More ELC patients had at least partial recovery (70% vs 64%). Although ELC had slightly higher rates of immediate post-operative complications (bile leak: 14% vs 11%; retained stone: 13% vs 9%; pancreatitis: 15% vs 12%), these were managed successfully with endoscopic treatment (ERCP rates: 9% vs 11%). ELC also led to a slightly shorter total hospital stay:
Conclusion: Cholecystectomy is associated with superior long-term outcomes, including significantly reduced disease recurrence and healthcare reutilization, as well as better functional recovery. The modest increase in early, manageable complications does not outweigh these benefits. Taken together, the findings strongly support ELC as the preferred strategy for managing uncomplicated acute gallstone disease.
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Dr Sami Ul Haq
Timergara Teaching Hospital, Dir Lower, Pakistan.
