Perioperative Complications in Patients of Acute Cholecystitis, Early Laparoscopic Cholecystectomy versus Interval Laparoscopic Cholecystectomy; A Comparative Study

Authors

  • Najmul Hassan Department of General Surgery, Combined Military Hospital/National University of Medical Sciences (NUMS), Rawalpindi Pakistan
  • Shahid Mehmood Khan Department of General Surgery, Combined Military Hospital/National University of Medical Sciences (NUMS), Rawalpindi Pakistan
  • Khurram Bajwa Department of General Surgery, Combined Military Hospital/National University of Medical Sciences (NUMS), Rawalpindi Pakistan
  • Syed Mukarram Hussain Department of General Surgery, Combined Military Hospital/National University of Medical Sciences (NUMS), Rawalpindi Pakistan
  • Wajeeha Batool Department of Gynecology, Azeem Hospital, Rawalpindi Pakistan
  • Imran Ashraf Department of General Surgery, Combined Military Hospital/National University of Medical Sciences (NUMS), Rawalpindi Pakistan

DOI:

https://doi.org/10.51253/pafmj.v74i6.10064

Keywords:

Acute Cholecystitis, Complications, Early, Interval, Laparoscopic Cholecystectomy.

Abstract

Objective: To compare the frequency of perioperative complications in patients with acute cholecystitis who undergo “early laparoscopic cholecystectomy” versus those who have “interval laparoscopic cholecystectomy”.

Study Design: Quasi-experimental study.

Place and Duration of Study: Combined Military Hospital, Rawalpindi Pakistan, from Aug 2022 to May 2023.

Methodology: This study included all the patients who had acute cholecystitis and were admitted to the surgery ward for its management. Half of the patients were selected who underwent early laparoscopic cholecystectomy, while the remaining half had interval laparoscopic cholecystectomy. The frequency of perioperative complications was noted in both groups.

Results: In our study, we included 50 patients (25 in group-A, who had “early laparoscopic cholecystectomy” while 25 in group-B, who had “interval laparoscopic cholecystectomy”). The mean age of the study population was 43.70±5.91 years. 18(36.00%) were male while the remaining 32(64.00%) were female. In our study, frequency of perioperative complications in group-A was injury to common bile duct 2(8.00%), biliary leak 3(12.00%), haemorrhage 4(16.00%) and conversion to open cholecystectomy 1(4.00%) while in group-B these were 0(0.00%), 1(4.00%), 2(8.00%) and 0(0.00%), respectively [with corresponding p-values of 0.149, 0.297, 0.384 and 0.312, respectively.

Conclusion: Interval laparoscopic cholecystectomy is a better surgical treatment option for patients with “acute cholecystitis”.

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Author Biographies

  • Najmul Hassan, Department of General Surgery, Combined Military Hospital/National University of Medical Sciences (NUMS), Rawalpindi Pakistan

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  • Khurram Bajwa, Department of General Surgery, Combined Military Hospital/National University of Medical Sciences (NUMS), Rawalpindi Pakistan
     

References

Lavoie B, Nausch B, Zane EA, Leonard MR, Balemba OB, Bartoo AC, et al. Disruption of gallbladder smooth muscle function is an early feature in the development of cholesterol gallstone disease. Neurogastroenterol Motil 2012; 24(7): e313-324.

https://doi.org/10.1111/j.1365-2982.2012.01935.x

Shaffer EA. Epidemiology and risk factors for gallstone disease: has the paradigm changed in the 21st century? Curr Gastroenterol Rep 2005; 7(2): 132-140.

https://doi.org/10.1007/s11894-005-0051-8

Salinas G, Velásquez C, Saavedra L, Ramírez E, Angulo H, et al. Prevalence and risk factors for gallstone disease. Surg Laparosc Endosc Percutan Tech 2004; 14(5): 250-253.

https://doi.org/10.1097/00129689-200410000-00003

Diehl AK. Symptoms of gallstone disease. Baillieres Clin Gastroenterol 1992; 6(4): 635-657.

https://doi.org/10.1016/0950-3528(92)90044-f

Morrow DJ, Thompson J, Wilson SE. Acute cholecystitis in the elderly: a surgical emergency. Arch Surg 1978; 113(10): 1149-1152. https://doi.org/10.1001/archsurg.1978.01370220035006

Hirota M, Takada T, Kawarada Y, Nimura Y, Miura F, Hirata K, et al. Diagnostic criteria and severity assessment of acute cholecystitis: Tokyo Guidelines. J Hepatobiliary Pancreat Surg 2007; 14(1): 78-82. https://doi.org/10.1007/s00534-006-1159-4

Soper NJ, Stockmann PT, Dunnegan DL, Ashley SW. Laparoscopic cholecystectomy. The new 'gold standard'? Arch Surg 1992; 127(8): 917-923.

https://doi.org/ 10.1001/archsurg.1992.01420080051008

Tekin A, Küçükkartallar T, Belviranli M, Vatansev C, Aksoy F, Tekin S, et al. Akut kolesistit için erken laparoskopik kolesistektomi [Early laparoscopic cholecystectomy for acute cholecystitis]. Ulus Travma Acil Cerrahi Derg. 2009; 15(1): 62-66.

Gurusamy K, Samraj K, Gluud C, Wilson E, Davidson BR. Meta-analysis of randomized controlled trials on the safety and effectiveness of early versus delayed laparoscopic cholecystectomy for acute cholecystitis. Br J Surg 2010; 97(2): 141-150. https://doi.org/10.1002/bjs.6870

Lau H, Lo CY, Patil NG, Yuen WK. Early versus delayed-interval laparoscopic cholecystectomy for acute cholecystitis: a metaanalysis. Surg Endosc 2006; 20(1): 82-87.

https://doi.org/10.1007/s00464-005-0100-2

Suresh K, Chandrashekara S. Sample size estimation and power analysis for clinical research studies. J Hum Reprod Sci 2012; 5(1): 7-13. https://doi.org/10.4103/0974-1208.97779

Ozkardeş AB, Tokaç M, Dumlu EG, Bozkurt B, Ciftçi AB, Yetişir F, et al. Early versus delayed laparoscopic cholecystectomy for acute cholecystitis: a prospective, randomized study. Int Surg 2014; 99(1): 56-61.

https://doi.org/10.9738/INTSURG-D-13-00068.1

Gallaher JR, Charles A. Acute cholecystitis: A review. JAMA 2022; 327(10): 965-975. https://doi.org/10.1001/jama.2022.2350

Agrawal R, Sood KC, Agarwal B. Evaluation of early versus delayed laparoscopic cholecystectomy in acute cholecystitis. Surg Res Pract 2015; 2015: 349801.

https://doi.org/10.1155/2015/349801

Ghasemi A, Zahediasl S. Normality tests for statistical analysis: a guide for non-statisticians. Int J Endocrinol Metab 2012; 10(2): 486-489. https://doi.org/10.5812/ijem.3505

Zahur S, Rabbani S, Andrabi SIH, Ahmad H, Chaudry AM. Early vs interval cholecystectomy in acute cholecystitis: an experience at Ghurki Trust Teaching Hospital, Lahore. Pak J Med Health Sci 2014; 8(3): 778-781.

Chang TC, Lin MT, Wu MH, Wang MY, Lee PH. Evaluation of early versus delayed laparoscopic cholecystectomy in the treatment of acute cholecystitis. Hepatogastroenterology 2009; 56(89): 26-28.

Kolla SB, Aggarwal S, Kumar A, Kumar R, Chumber S, Parshad R, et al. Early vs delayed laparoscopic cholecystectomy for acute cholecystitis. A prospective randomized trial. Surg Endosc 2004; 18: 1323–1327. https://doi.org/10.1007/s00464-003-9230-6

Sánchez-Carrasco M, Rodríguez-Sanjuán JC, Martín-Acebes F, Llorca-Díaz FJ, Gómez-Fleitas M, Zambrano Muñoz R, et al. Evaluation of early cholecystectomy versus delayed cholecystectomy in the treatment of acute cholecystitis. HPB Surg 2016: 4614096. https://doi.org/10.1155/2016/4614096

Hegazy TO, Soliman SS. Early versus interval laparoscopic cholecystectomy for treatment of noncomplicated acute calcular cholecystitis. Egypt J Surg 2018; 37(4): 543-548.

https://doi.org/10.4103/ejs.ejs_82_18

Lyu Y, Cheng Y, Wang B, Zhao S, Chen L. Early versus delayed laparoscopic cholecystectomy for acute cholecystitis: an up-to-date meta-analysis of randomized controlled trials. Surg Endosc 2018; 32(12): 4728-4741.

https://doi.org/10.1007/s00464-018-6400-0

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Published

31-12-2024

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Original Articles

How to Cite

1.
Hassan N, Khan SM, Bajwa K, Hussain SM, Batool W, Ashraf I. Perioperative Complications in Patients of Acute Cholecystitis, Early Laparoscopic Cholecystectomy versus Interval Laparoscopic Cholecystectomy; A Comparative Study. Pak Armed Forces Med J [Internet]. 2024 Dec. 31 [cited 2025 Feb. 22];74(6):1584-7. Available from: https://pafmj.org/PAFMJ/article/view/10064