Observation on Early Cholecystectomy in Acute Cholecystitis

Quest for remedy for gall stone has marched from the ancient age of simple removal of stones by creating a biliary fistula to cholecystostomy and then to open cholecystectomy followed by certain noninvasive steps like dissolution and lithotripsy to finally reach the present era of laparoscopic cholecystectomy. The aim of this study is to observe various perioperative and postoperative parameters in patients undergoing early cholecystectomy for acute cholecystitis.

A prospective study was carried out from April 2007 to April 2009. 50 patients who have been admitted to Bokaro General Hospital, Bokaro Steel City, Jharkhand, with acute cholecystitis were operated within 7 days of onset of disease.

In 25 cases open cholecystectomy was done, in 25 cases laparoscopic cholecystectomy was done out of which 4 cases were converted to open cholecystectomy in our study Patients who underwent laparoscopic cholecystectomy had a significantly lower rate of complications {4 patients(19.04%)} than those underwent open cholecystectomy {9 patients(36%)}. The total average costs per patient for open cholecystectomy, laparoscopic cholecystectomy and for laparoscopic to open cholecystectomy were 10974.88 Rs, 10783.57 Rs, 12931.25 Rs respectively. There was no mortality during this present observation.

Early cholecystectomy (Open or Laparoscopic) prevents complications of delayed operation, shorten time of treatment, lowers costs of treatment, shorten period of hospitalization, shorten period of work incapacity and also have a favourable psychological effect. Early laparoscopic intervention is safe and feasible than open cholecystectomy and significantly reduced operative blood loss, hospital days and hospital charges.