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Early versus delayed laparoscopic cholecystectomy with and without percutaneous drainage for complicated acute calculous cholecystitis: A prospective randomized study

Mohamed Ibrahim Kassem.

Abstract
Objective: The purpose of this research was to compare surgical consequences of early versus delayed laparoscopic cholecystectomy for complicated acute calculous cholecystitis.
Patients and Methods: This prospective randomized work was conducted on 150 patients complaining of complicated acute calculous cholecystitis; presented to the Emergency Department, Alexandria Main University Hospital, Egypt, between January 2011 and January 2017. They were distributed randomly into two groups (75 patients each): Group (A) for early laparoscopic cholecystectomy and Group (B) for delayed laparoscopic cholecystectomy.
Results: There were 42 men and 108 women. Their mean age at diagnosis was 39.6±10.27 years. The timing of surgery since onset of patients’ complains was ranged from 1.0 to 7.0 days in Group A and from 6 to 10 weeks in Group B. Acute abdominal pain was present in both groups patients. Preoperative CT scan was done for 60 patients (40%) to verify the presence of complications. The mean operative time in Group A and Group B patients were 71.0±26.93 and 38.0±26.25 minutes respectively and there was a statistically significant difference (p>0.054). Laparoscopic cholecystectomy was converted to open procedure in ten patients. The mean hospital stay in patients of Group A was 1.76±1.05 while in patients of Group B was 3.87±2.43 in the first admission and 2.72±1.41 in second admission. There was no major bile duct injury or post-operative obstructive jaundice in either group. In six patients (2 in Group A and 4 in Group B) bile leak was noted from the drain and port sites’ infections were found in eight patients.
Conclusion: Early laparoscopic cholecystectomy one week from start of symptoms of complicated acute calculous cholecystitis; was safe, feasible, and considered an acceptable indication.

Key words: Early laparoscopic cholecystectomy, delayed laparoscopic cholecystectomy, complicated acute calculous cholecystitis, conversion rates


 
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Pubmed Style

Mohamed Ibrahim Kassem. Early versus delayed laparoscopic cholecystectomy with and without percutaneous drainage for complicated acute calculous cholecystitis: A prospective randomized study. Arch Clin Exp Surg. 2018; 7(2): 47-58. doi:10.5455/aces.20170503081122


Web Style

Mohamed Ibrahim Kassem. Early versus delayed laparoscopic cholecystectomy with and without percutaneous drainage for complicated acute calculous cholecystitis: A prospective randomized study. http://www.ejmaces.com/?mno=254510 [Access: November 13, 2018]. doi:10.5455/aces.20170503081122


AMA (American Medical Association) Style

Mohamed Ibrahim Kassem. Early versus delayed laparoscopic cholecystectomy with and without percutaneous drainage for complicated acute calculous cholecystitis: A prospective randomized study. Arch Clin Exp Surg. 2018; 7(2): 47-58. doi:10.5455/aces.20170503081122



Vancouver/ICMJE Style

Mohamed Ibrahim Kassem. Early versus delayed laparoscopic cholecystectomy with and without percutaneous drainage for complicated acute calculous cholecystitis: A prospective randomized study. Arch Clin Exp Surg. (2018), [cited November 13, 2018]; 7(2): 47-58. doi:10.5455/aces.20170503081122



Harvard Style

Mohamed Ibrahim Kassem (2018) Early versus delayed laparoscopic cholecystectomy with and without percutaneous drainage for complicated acute calculous cholecystitis: A prospective randomized study. Arch Clin Exp Surg, 7 (2), 47-58. doi:10.5455/aces.20170503081122



Turabian Style

Mohamed Ibrahim Kassem. 2018. Early versus delayed laparoscopic cholecystectomy with and without percutaneous drainage for complicated acute calculous cholecystitis: A prospective randomized study. Archives of Clinical and Experimental Surgery (ACES), 7 (2), 47-58. doi:10.5455/aces.20170503081122



Chicago Style

Mohamed Ibrahim Kassem. "Early versus delayed laparoscopic cholecystectomy with and without percutaneous drainage for complicated acute calculous cholecystitis: A prospective randomized study." Archives of Clinical and Experimental Surgery (ACES) 7 (2018), 47-58. doi:10.5455/aces.20170503081122



MLA (The Modern Language Association) Style

Mohamed Ibrahim Kassem. "Early versus delayed laparoscopic cholecystectomy with and without percutaneous drainage for complicated acute calculous cholecystitis: A prospective randomized study." Archives of Clinical and Experimental Surgery (ACES) 7.2 (2018), 47-58. Print. doi:10.5455/aces.20170503081122



APA (American Psychological Association) Style

Mohamed Ibrahim Kassem (2018) Early versus delayed laparoscopic cholecystectomy with and without percutaneous drainage for complicated acute calculous cholecystitis: A prospective randomized study. Archives of Clinical and Experimental Surgery (ACES), 7 (2), 47-58. doi:10.5455/aces.20170503081122





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