Timing of Early Cholecystectomy for Acute Calculous Cholecystitis: A Multicentric Prospective Observational Study

Paola Fugazzola, Fikri M. Abu-Zidan, Lorenzo Cobianchi, Francesca Dal Mas, Marco Ceresoli, Federico Coccolini, Simone Frassini, Matteo Tomasoni, Fausto Catena, Luca Ansaloni

Research output: Contribution to journalArticlepeer-review

Abstract

The definition of Early Cholecystectomy (EC) is still debatable. This paper aims to find whether the timing of EC affects outcomes. The article reports a multicentric prospective observational study including patients with acute calculous cholecystitis (ACC) who had cholecystectomy within ten days from the onset of symptoms. Kruskall-Wallis test, Fisher’s Exact test, and Spearman rank correlation were used for statistical analysis. The patients were divided into three groups depending on the timing of the operation: 0–3 days, 4–7 days, or 8–10 days from the onset of symptoms. 1117 patients were studied over a year. The time from the onset of symptoms to EC did not affect the post-operative complications and mortality, the conversion, and the reintervention rate. The time represented a significant risk factor for intraoperative complications (0–3 days, 2.8%; 4–7 days, 5.6%; 8–10 days, 7.9%; p = 0.01) and subtotal cholecystectomies (0–3 days, 2.7%; 4–7 days, 5.6%; 8–10 days, 10.9%; p < 0.001). ACC is an evolutive inflammatory process and, as the days go by, the local and systemic inflammation increases, making surgery more complex and difficult with a higher risk of intraoperative complications. We recommend performing EC for ACC as soon as possible, within the first ten days of the onset of symptoms.

Original languageEnglish
Article number2752
JournalHealthcare (Switzerland)
Volume11
Issue number20
DOIs
Publication statusPublished - Oct 2023

Keywords

  • acute cholecystitis
  • cholecystectomy
  • complication
  • mortality
  • surgery
  • timing

ASJC Scopus subject areas

  • Leadership and Management
  • Health Policy
  • Health Informatics
  • Health Information Management

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