Does early cholecystectomy for acute cholecystitis improve outcomes?

  • Wiggins T & al.
  • Surg Endosc
  • 4 Apr 2019

  • curated by Pavankumar Kamat
  • UK Medical News
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According to a new study published in the journal Surgical Endoscopy, emergency cholecystectomy performed within 3 days of hospital admission is associated with lower rates of intra-operative conversion, post-surgical biliary complications and shorter hospital stays.

Researchers analysed data of patients, who underwent cholecystectomy for acute cholecystitis on index admission in England, obtained from the Hospital Episodes Statistics database (n=43,870). Patients were categorised as per the timing of cholecystectomy on index admission: 0-3 days after admission, 4-7 days or ≥8 days.

The rates of intra-operative laparoscopic conversion to open surgery were 3.6 per cent, 4.0 per cent and 4.7 per cent for cholecystectomy at 0-3, 4-7 and ≥8 days, respectively. For cholecystectomy at 0-3, 4-7 and ≥8 days, the rates of post-operative endoscopic retrograde cholangiopancreatogram were 1.1 per cent, 1.5 per cent and 1.9 per cent, respectively; and the rates of bile duct injury were 0.6 per cent, 1.0 per cent and 1.8 per cent, respectively. Early cholecystectomy was also associated with a shorter length of stay following surgery.

The authors said: "By improving patient pathways and available infrastructure to facilitate widespread adoption of emergency cholecystectomy in the United Kingdom, it may be possible to further increase the proportion of patients receiving surgery within 3 days of admission and therefore improve clinical patient outcome."

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