Roulin D, Saadi A, Di mare L, Demartines N, Halkic N. Early Versus Delayed Cholecystectomy for Acute Cholecystitis, Are the 72 hours Still the Rule?: A Randomized Trial. Ann Surg. 2016;264(5):717-722.

Article link: Early Versus Delayed Cholecystectomy for Acute Cholecystitis Are the 72 hours Still the Rule – A Randomized Trial

Summary:

The randomized trial by Roulin D, et al from 2016 questioned if early cholecystectomy is still the best choice for patients with signs and symptoms of acute cholecystitis even after 72 hours of symptoms. The randomized trial has a small sample size of 86 patients. A comparison was done and the results o 42 patients who had surgery during the initial hospitalization (early laparoscopic cholecystectomy) and 44 patients who were initially treated with antibiotics and then had the surgery after a delay of about 6 weeks (delayed laparoscopic cholecystectomy). At baseline, there were no significant differences between the two groups in terms of age, gender, obesity or comorbidities.

The results of this RCT showed that the early surgery patients had a significant reduction in antibiotic use, length of hospital stay, readmission, and overall hospital bill.

In conclusion, it revealed an advantage for patients to have early laparoscopic cholecystectomy even after 3 days of symptoms. Its benefits is associated with less overall morbidity and less duration of antibiotic therapy as well as a significant reduction of hospital cost compared with delayed laparoscopic cholecystectomy.

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