Letter to the Editor

Early Laparoscopic Cholecystectomy for Acute Cholecystitis: Is It Safe for Patients?

Authors: Rajesh Nair, BSc, MD

Abstract

To the Editor: There is still controversy in the literature about the best timing for surgery in treating acute cholecystitis. Proponents of early laparoscopic cholecystectomy argue that this technique may reduce morbidity, conversion rates, mortality, and hospital costs.1 Others favor delayed surgery (>7 days) because there is a belief that affected inflammatory tissue is more vulnerable to surgery and leads to an increased risk in complications.1 Does the literature contain evidence of better clinical outcome and lower complication rates with early surgery compared with delayed surgery?

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References

1. Gurusamy KS, Davidson C, Gluud C, et al. Early versus delayed laparoscopic cholecystectomy for people with acute cholecystitis. Cochrane Database Syst Rev 2013;6:CD005440.
 
2. Gutt CN, Encke J, Koninger J, et al. Acute cholecystitis: early versus delayed cholecystectomy, a multicenter randomized trial (ACDC study, NCT00447304). Ann Surg 2013;258:385-393.
 
3. Ozkardez AB, Toka0 M, Dumlu EG, et al. Early versus delayed laparoscopic cholecystectomy for acute cholecystitis: a prospective, randomized study. Int Surg 2014;99:56-61.
 
4. Pieniowski E, Popowicz A, Lundell L, et al. Early versus delayed surgery for acute cholecystitis as an applied treatment strategy when assessed in a population-based cohort. Dig Surg 2014;31:169-176.