{"title":"Early versus delayed laparoscopic cholecystectomy in uncomplicated biliary colic: An observational study","authors":"Krishnendu Vidyadharan, Rajkumar KembaiShanmugam, Ganesan Ayyasamy, Satheshkumar Thandayuthapani","doi":"10.1016/j.lers.2023.05.005","DOIUrl":null,"url":null,"abstract":"<div><h3>Objective</h3><p>Biliary colic is a condition treated with laparoscopic cholecystectomy. However, the outcomes of surgery depend on early or delayed time points. Few research findings reported no benefits of early over delayed, on contra, other reported benefits. This study aims to compare the benefits associated with early and delayed laparoscopic cholecystectomy among uncomplicated biliary colic patients.</p></div><div><h3>Methods</h3><p>This observational study included patients with right upper abdominal pain and abdominal ultrasound showing cholelithiasis. Patients who were admitted at the first and second visits (within 6 weeks of the first visit) were assigned to the early and delayed groups, respectively. All participants were followed up for one-week postsurgery. The diagnosis of the patient, postoperative hospital stay, duration of surgery and complications were noted and compared primarily.</p></div><div><h3>Results</h3><p>A total of 80 patients were included, 40 each in the early group and delayed group. The patients in the two groups had comparable mean ages (40.55 ± 13.12 y vs. 40.45 ± 12.06 y, <em>p</em> = 0.972). The early group had more female patients (72.5% vs. 45.0%, <em>p</em> = 0.012). The duration of hospital stay (2.18 ± 0.38 d vs. 2.68 ± 1.04 d, <em>p</em> = 0.009) and duration of surgery (61.63 ± 3.64 min vs. 71.13 ± 16.19 min, <em>p</em> = 0.001) were found to be significantly different between the early and delayed groups. Only 1 (2.5%) patient in both groups was converted to open cholecystectomy. Recurrent biliary colic requiring hospital admission was seen in 1 (2.5%) patient and 6 (15.0%) patients, acute cholecystitis in 2 (5.0%) and 6 (15.0%), biliary pancreatitis in 1 (2.5%) and 2 (5.0%), and obstructive jaundice in 1 (2.5%) and 1 (2.5%) in the early and delayed groups, respectively, with insignificant differences (<em>p</em> > 0.05).</p></div><div><h3>Conclusion</h3><p>Early laparoscopic cholecystectomy decreases the operating time and duration of hospital stay. In terms of postoperative complications, our study did not find any significant difference between the groups.</p></div>","PeriodicalId":32893,"journal":{"name":"Laparoscopic Endoscopic and Robotic Surgery","volume":"6 2","pages":"Pages 69-72"},"PeriodicalIF":0.0000,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"1","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Laparoscopic Endoscopic and Robotic Surgery","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2468900923000269","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"Medicine","Score":null,"Total":0}
引用次数: 1
Abstract
Objective
Biliary colic is a condition treated with laparoscopic cholecystectomy. However, the outcomes of surgery depend on early or delayed time points. Few research findings reported no benefits of early over delayed, on contra, other reported benefits. This study aims to compare the benefits associated with early and delayed laparoscopic cholecystectomy among uncomplicated biliary colic patients.
Methods
This observational study included patients with right upper abdominal pain and abdominal ultrasound showing cholelithiasis. Patients who were admitted at the first and second visits (within 6 weeks of the first visit) were assigned to the early and delayed groups, respectively. All participants were followed up for one-week postsurgery. The diagnosis of the patient, postoperative hospital stay, duration of surgery and complications were noted and compared primarily.
Results
A total of 80 patients were included, 40 each in the early group and delayed group. The patients in the two groups had comparable mean ages (40.55 ± 13.12 y vs. 40.45 ± 12.06 y, p = 0.972). The early group had more female patients (72.5% vs. 45.0%, p = 0.012). The duration of hospital stay (2.18 ± 0.38 d vs. 2.68 ± 1.04 d, p = 0.009) and duration of surgery (61.63 ± 3.64 min vs. 71.13 ± 16.19 min, p = 0.001) were found to be significantly different between the early and delayed groups. Only 1 (2.5%) patient in both groups was converted to open cholecystectomy. Recurrent biliary colic requiring hospital admission was seen in 1 (2.5%) patient and 6 (15.0%) patients, acute cholecystitis in 2 (5.0%) and 6 (15.0%), biliary pancreatitis in 1 (2.5%) and 2 (5.0%), and obstructive jaundice in 1 (2.5%) and 1 (2.5%) in the early and delayed groups, respectively, with insignificant differences (p > 0.05).
Conclusion
Early laparoscopic cholecystectomy decreases the operating time and duration of hospital stay. In terms of postoperative complications, our study did not find any significant difference between the groups.
期刊介绍:
Laparoscopic, Endoscopic and Robotic Surgery aims to provide an academic exchange platform for minimally invasive surgery at an international level. We seek out and publish the excellent original articles, reviews and editorials as well as exciting new techniques to promote the academic development.
Topics of interests include, but are not limited to:
▪ Minimally invasive clinical research mainly in General Surgery, Thoracic Surgery, Urology, Neurosurgery, Gynecology & Obstetrics, Gastroenterology, Orthopedics, Colorectal Surgery, Otolaryngology, etc.;
▪ Basic research in minimally invasive surgery;
▪ Research of techniques and equipments in minimally invasive surgery, and application of laparoscopy, endoscopy, robot and medical imaging;
▪ Development of medical education in minimally invasive surgery.