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  • Title: [Acute cholecystitis--early or delayed cholecystectomy].
    Author: Petaković G, Korica M, Gavrilović S.
    Journal: Med Pregl; 2002; 55(3-4):135-9. PubMed ID: 12070931.
    Abstract:
    INTRODUCTION: In our population biliary tract diseases are the most frequent surgical entity. If the diagnosis of acute cholecystitis is relatively clear and the time from onset of the disease does not exceed 72 hours, early cholecystectomy is recommended. The aim of this prospective study was to use certain analytical procedures in order to compare early and late results of early and delayed cholecystectomy. MATERIAL AND METHODS: 240 patients were divided into two groups: Group I: patients treated by early cholecystectomy and Group II: patients treated by delayed cholecystectomy. We compared the following: intraoperative findings, postoperative morbidity and mortality, complications, average number of patient-days and histopathological changes. RESULTS: During the investigated period (1998-1999), 599 (35.95%) patients with acute and 1.067 (64.05%) patients with chronic cholecystitis were treated at the Clinic of Abdominal and Endocrine Surgery of the Clinical Center Novi Sad. Out of 599 patients with acute cholecystitis, 489 (81.63%) patients underwent surgery, whereas 110 (18.37%) were treated conservatively. In regard to chronic cholecystitis, 963 (90.25%) patients were surgically treated, and 104 (9.75%) patients were conservatively treated. All patients from Group I were operated within 24-48 hours from onset of the disease or during 24 hours of hospitalization. They were hospitalized due to signs of cholecystitis for the first time, whereas this was the second hospitalization for all patients from Group II, 42 +/- 2.3 days after first hospitalization on average. Regarding sick leave in Group I patients it was calculated as follows: hospital days + home treatment and it made 32 +/- 3.7 days. In Group II it was calculated as follows: first hospitalization + home treatment + second hospitalization + home treatment making 53 +/- 6.7 days. CONCLUSIONS: The number and type of early and late complications in Group II patients justifies early cholecystectomy; in acute cholecystitis, cholecystectomy should be performed within 24-48 hours from the onset of the disease; in regard to late, early cholecystectomies are characterized by significantly shorter period of recovery and sick leave.
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