Early vs interval Laparoscopic Cholecystectomy in the management of symptomatic gallstones
Keywords:Cholecystectomy, Laparoscopic. Gallstones. Cholelithiasis. Cholecystitis. Cholecystitis, Acute. Cholangiography. Bile Ducts. Cholangiopancreatography, Endoscopic Retrograde. Bile Duct Diseases.
One hundred and fifty one patients that underwent laparoscopic cholecystectomy at Princess Alexandra Hospital Harlow were identified between January 2005 and October 2005. They were grouped according to their diagnosis (biliary colic, acute cholecystitis, CBD stones, gallstone pancreatitis) and the delay until their operation (early, interval). The delay for an interval operation was between 3 and 6 months compared with less than 2 weeks for early operations. No disadvantage was found for early LC for biliary colic. Interval cholecystectomy for all symptomatic gallstones was associated with multiple pre-operative presentations particularly if the initial presentation was to A&E (p=0.003). Complication rates were also higher. Early cholecystectomy on the next available list should be recommended for all patients presenting to general surgical teams to lower morbidity and the long-term inpatient burden from gallstones.
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