We aimed to compare the clinical outcome and cost of early versus delayed laparoscopic cholecystectomy for acute cholecystitis. Sixty patients with acute cholecystitis were randomized into early (within 24 hours of admission) or delayed (after 6-8 weeks of conservative treatment) laparoscopic cholecystectomy groups. There was no significant difference between study groups in terms of operation time and rates for conversion to open cholecystectomy. On the other hand, total hospital stay was longer (5.2 6 1.40 versus 7.8 6 1.65 days; P ¼ 0.04) and total costs were higher (2500.97 6 755.265 versus 3713.47 6 517.331 Turkish Lira; P ¼ 0.03) in the delayed laparoscopic cholecystectomy group. Intraoperative and postoperative complications were recorded in 8 patients in the early laparoscopic cholecystectomy group, whereas no complications occurred in the delayed laparoscopic cholecystectomy group (P ¼ 0.002). Despite intraoperative and postoperative complications being associated more with early laparoscopic cholecystectomy compared with delayed intervention, early laparoscopic cholecystectomy should be preferred for treatment of acute cholecystitis because of its advantages of shorter hospital stay and lower cost.

Abstract:Introduction: Riedel thyroiditis is a form of thyroiditis characterised by inflammatory proliferative fibrotic process leading to destruction of thyroid gland and its capsule until reaching the surrounding tissue. Case Report: Herein, the placement of intratracheal stent along with surgical treatment is discussed in a patient of Riedel thyroiditis with pressure symptoms and nonresponsive to medical treatment. Discussion: Patients usually present with hard enlarged mass in the neck and pressure symptoms. Surgical treatment may be required when tracheal and esophageal pressure symptoms occur. Since Riedel thyroiditis involves surrounding tissues as well, it prevents a thyroidectomy at surgical anatomic plane and increases the probability of injury to recurrent laryngeal nerve and parathyroid glands. Conclusion: When pressure symptoms recur in patients with Riedel thyroidits, who were operated previously, the placement of intratracheal permanent stent should be kept in mind among treatment options.