Early Cholecystectomy Is Superior to Delayed Cholecystectomy for Acute Cholecystitis: a Meta-analysis

Abstract

Early laparoscopic cholecystectomy in acute cholecystitis demonstrated decreased incidence of wound infections, a shorter total length of stay and decreased costs with no difference in the rates of mortality, bile duct injuries, bile leaks and conversions. These results support that early laparoscopic cholecystectomy is the best care and should be considered a routine in patients presenting with acute cholecystitis.

414 The Sooner the Better-The Importance of Optimal Timing of Cholecystectomy in Acute Cholecystitis. Data From the National Swedish Registry for Gallstone Surgery, Gallriks (2006 to 2014)

“…[12][13][14] Recent meta-analyses concluded that early laparoscopic cholecystectomy appears to be safe and reduces total hospital stay. [15][16][17] Similar conclusions were also reached in a current Cochrane systemic review. 18 A recent multicenter (n = 35 centers) randomized trial (n = 618 patients), studying early versus delayed cholecystectomy, finally settled the issue showing that laparoscopic cholecystectomy, when performed within 24 h of hospital admission, was significantly better as compared to conservative treatment regarding both morbidity and costs.…”

Early Cholecystectomy for Acute Cholecystitis in the Elderly Population: A Systematic Review and Meta-Analysis

“…These rates are higher than reported for non-elderly patients undergoing emergency cholecystectomy for acute cholecystitis, which has been extensively investigated in previous studies, being approximately 15 and <1%, respectively [25] . Yet, 4 of the 5 included studies comparing perioperative outcomes of early cholecystectomy in elderly and younger patients showed no significant difference in terms of perioperative morbidity or mortality [17][18][19]21] .…”

“…Studies focusing on non-elderly patients undergoing early cholecystectomy for acute cholecystitis demonstrated a conversion rate from laparoscopic to OC of 13% [25] . The present study showed a conversion rate of 23%.…”

Early laparoscopic cholecystectomy is superior to delayed acute cholecystitis: a meta-analysis of case–control studies

“…With the results of recent randomized controlled trials (RCT) and meta-analyses of RCT, it has been accepted that patients undergoing early LC have significantly shorter total length of hospital stay compared with delayed LC [12]. Other clinical outcomes including mortality, complication rates and conversions to open procedure appear to favour early LC, but were not statistically significant.…”