A Comparative Study between Early Versus Delayed Laparoscopic Cholecystectomy for Acute Cholecystitis in a Tertiary Care Center of Nepal

A. Koirala, Ram Sagar Shah, Sachidanand Shah, D. Adhikari, A. Bhattarai, Richa Niraula, A. Yadav
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Abstract

Background: Laparoscopic Cholecystectomy is considered as a gold standard treatment for symptomatic cholelithiasis. The timing of surgery for acute Cholecystitis is still controversial, weather to go early surgery or wait for six to eight weeks after conservative management. Therefore, the aim of this study is to compare the clinical outcomes of early versus delayed laparoscopic cholecystectomy for acute Cholecystitis. Materials and Methods: A prospective study was conducted in Nobel Medical College Teaching Hospital, Biratnagar, Nepal. Total of 80 patients with the diagnosis of acute Cholecystitis were enrolled in the study. The patients were equally divided in two groups: 40 underwent early laparoscopic cholecystectomy within 72 hours of admission (Group A) and next 40 underwent delayed laparoscopic cholecystectomy after 6-8 weeks of conservative management (Group B). Results: Out of 80 patients of acute Cholecystitis, mean age of the patients in Group A was 43.40±13.45 years and that in Group B was 44.80±14.36 years. The mean operative time in Group A was 90.22±2.81 minutes whereas in Group B it was 80.97±4.47 minutes. Mean duration of Hospital stay in Group A was 2.02±0.15 days whereas in Group B it was 2.15±0.36 days. Two patients in Group A and one patient in Group B converted to open cholecystectomy. Three patients of Group A and one patient of Group B landed in outpatient department with superficial surgical site infection.  Group B patients underwent second hospital admission compared to Group A patients. Conclusion: Early Laparoscopic cholecystectomy for acute cholecystitis is almost comparable with delayedLaparoscopic cholecystectomy. However, early laparoscopic cholecystectomy reduces the morbidity of patients as well as it is cost-effectiveness.
尼泊尔三级医疗中心早期与延迟腹腔镜胆囊切除术治疗急性胆囊炎的比较研究
背景:腹腔镜胆囊切除术被认为是治疗症状性胆石症的金标准。急性胆囊炎的手术时机仍有争议,是早期手术还是保守治疗后等待6 - 8周。因此,本研究的目的是比较早期和延迟腹腔镜胆囊切除术治疗急性胆囊炎的临床结果。材料与方法:在尼泊尔比拉特纳格尔诺贝尔医学院教学医院进行前瞻性研究。共有80名诊断为急性胆囊炎的患者参加了这项研究。患者平均分为两组:入院72小时内行早期腹腔镜胆囊切除术40例(A组),保守治疗6-8周后行延迟腹腔镜胆囊切除术40例(B组)。结果:80例急性胆囊炎患者中,A组平均年龄43.40±13.45岁,B组平均年龄44.80±14.36岁。A组平均手术时间为90.22±2.81分钟,B组平均手术时间为80.97±4.47分钟。A组平均住院时间为2.02±0.15 d, B组平均住院时间为2.15±0.36 d。A组2例,B组1例转为开腹胆囊切除术。A组3例,B组1例因手术部位浅表感染住院。与A组患者相比,B组患者第二次住院。结论:急性胆囊炎早期腹腔镜胆囊切除术与延迟腹腔镜胆囊切除术疗效相当。然而,早期腹腔镜胆囊切除术降低了患者的发病率,并且具有成本效益。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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