TITLE

Management of acute cholecystitis in the laparoscopic era: Results of a prospective, randomized clinical trial

AUTHOR(S)
Johansson, Mikael; Thune, A.; Blomqvist, A.; Nelvin, L.; Lundell, L.
PUB. DATE
July 2003
SOURCE
Journal of Gastrointestinal Surgery;Jul2003, Vol. 7 Issue 5, p642
SOURCE TYPE
Academic Journal
DOC. TYPE
journal article
ABSTRACT
The aim of this prospective, randomized study was to determine whether laparoscopic cholecystectomy should be performed as an early or a delayed operation in patients with acute cholecystitis. After diagnostic workup, patients were randomized to one of two groups: (1) early laparoscopic cholecystectomy (i.e., within 7 days after onset of symptoms) or (2) initial conservative treatment followed by delayed laparoscopic cholecystectomy 6 to 8 weeks later. Seventy-four patients were placed in the early-operation group, and 71 patients were assigned to the delayed-operation strategy. There was no significant difference in conversion rates (early 31% vs. delayed 29%), operating times (early 98 [range 30 to 355] minutes vs. delayed 100 [45 to 280] minutes), or complications. Failure with the conservative treatment strategy was noted in 26% of these patients. The total hospital stay was significantly shorter in the early group (5 [range 3 to 63] days) vs. the delayed group (8 [range 4 to 50] days; P<0.05). Despite a high conversion rate, early laparoscopic cholecystectomy offered significant advantages in the management of acute cholecystitis compared to a conservative strategy. The greatest advantage was a reduced total hospital stay.
ACCESSION #
10176595

 

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