Early vs. Interval Laparoscopic Cholecystectomy in Acute Cholecystitis

Abstract

Background: Acute cholecystitis is a common surgical emergency for which the optimal timing of laparoscopic cholecystectomy remains debated, particularly in resource-limited settings, with limited regional data directly comparing early versus interval surgical approaches. Objective: This study aimed to compare operative time, hospital stay, and conversion rates to open surgery between early laparoscopic cholecystectomy within 72 hours and interval laparoscopic cholecystectomy after four weeks in patients with acute cholecystitis. Methods: In this single-center randomized controlled trial, 166 adult patients (aged 20–60 years) with acute cholecystitis, meeting predefined inclusion and exclusion criteria, were randomly assigned to either early (n = 83) or interval (n = 83) laparoscopic cholecystectomy. All procedures were performed by a single experienced surgeon using a standardized four-port technique. Clinical and demographic data were collected using structured forms, and primary outcomes included operative time, hospital stay, and conversion to open surgery. Data analysis was performed with SPSS version 20, utilizing independent t-tests and chi-square tests; ethical approval was obtained from the institutional review board in accordance with the Helsinki Declaration. Results: Early laparoscopic cholecystectomy resulted in significantly shorter mean operative time (58.4 ± 14.2 vs 71.8 ± 18.6 minutes, p < 0.001), reduced hospital stay (1.6 ± 1.8 vs 2.4 ± 2.1 days, p = 0.008), and lower conversion rates to open surgery (6.0% vs 16.9%, p = 0.032) compared to interval surgery, with comparable complication rates. Conclusion: Early laparoscopic cholecystectomy offers substantial operative and recovery benefits over interval surgery for acute cholecystitis, supporting its adoption as the standard of care and highlighting its value in both clinical and real-world healthcare practice.