Outcomes of patients presenting with Cholecystitis in terms of Early vs Delayed Cholecystectomy

  • Maryam Qaiser
  • Maryyam Rehan RMU
  • Khurram Siddique
  • Muhammad Idrees Anwar
  • Omer Habib Khan
  • Kausar Rehan
Keywords: Cholelithiasis, Pancreatitis, Cholecystectomy


Introduction: Biliary tract diseases comprise the most frequently occurring pathology in the abdomen, among which cholelithiasis affects 10-15% of the population.  Early laparoscopic cholecystectomy, performed within 72 hours 2) Interval laparoscopic cholecystectomy, performed within 72 hours to 6 weeks 3) Delayed laparoscopic cholecystectomy in which patients are treated with antibiotics and given date of surgery within 6-8 weeks according to international criteria.

Objective: To find out the variability between hot, urgent, and delayed laparoscopic cholecystectomy in terms of clinical complications and to find out the readmission rate, the persistence of symptoms, and the safety of the procedure.

Materials and Methods: This is a retrospective study carried out in the Surgical Unit ll, Holy Family Hospital, Rawalpindi from January 2018 to March 2018. All adult male and female patients presenting with acute cholecystitis and pancreatitis were included in the study.

Results: Total number of patients included in our study is 82. Most of the patients were female 80.5% with a mean age of 44 years. Most of the patients were categorized under delayed laparoscopic cholecystectomy 93.9%, 6.1% underwent interval/urgent cholecystectomy, and 1.2% early/hot cholecystectomy. Diagnosis in the study showed acute cholecystitis in 79.3% of patients, pancreatitis in 7.3%, empyema /gangrene of gallbladder in 6.1% mucocele in 6.1%, and choledocholithiasis in 1.2% of patients. Hence we figured out that performing early cholecystectomy leads to lesser complications.

Conclusion: Early laparoscopic cholecystectomy was found out to be a safe and cost-effective procedure. There is an increased incidence of readmission and complications with delayed laparoscopic cholecystectomy. We suggest that measures must be taken in Pakistan to follow international guidelines in health practices to improve patient care.



1. Mustafa M, Mustafa A, … SC-PJMH, 2016 undefined. Early vs delayed laparoscopic cholecystectomy in acute cholecystitis. pjmhsonline.com. http://pjmhsonline.com/2016/april_june/pdf/371.pdf. Accessed March 24, 2019.
2. Minutolo V, Licciardello A, … MA-ERM, 2014 undefined. Laparoscopic cholecystectomy in the treatment of acute cholecystitis: comparison of outcomes and costs between early and delayed cholecystectomy. europeanreview.org. https://www.europeanreview.org/wp/wp-content/uploads/40-46.pdf. Accessed March 24, 2019.
3. Overview | Gallstone disease: diagnosis and management | Guidance | NICE. https://www.nice.org.uk/guidance/cg188. Accessed March 24, 2019.
4. Riaz M, Bhasin SK, Hussain T, Parvez M. Early vs late laproscopic cholecystectomy and effect of time on clinical severity, pathology and surgical outcome in patients of acute cholecystitis a prospective study. Journal of Evolution of Medical and Dental Sciences. 2015 Nov 16;4(92):15786-91. DOI:10.14260/jemds/2015/2285
5. MOREAU JA, ZINSMEISTER AR, MELTON III LJ, DiMAGNO EP. Gallstone pancreatitis and the effect of cholecystectomy: a population-based cohort study. InMayo Clinic Proceedings 1988 May 1 (Vol. 63, No. 5, pp. 466-473). Elsevier.
6. Rehman S, Afzal M, Journal MB-PAFM, 2017 undefined. Outcomes of laparoscopic cholecystectomy in acute cholecystitis. pafmj.org. http://pafmj.org/index.php/PAFMJ/article/view/133. Accessed March 24, 2019.
7. Eldar S, Eitan A, Bickel A, Sabo E, Cohen A, Abrahamson J, Matter I. The impact of patient delay and physician delay on the outcome of laparoscopic cholecystectomy for acute cholecystitis. The American journal of surgery. 1999 Oct 1;178(4):303-7.
8. Cholecystectomy Quality Improvement Collaborative (Chole-QuIC) — Royal College of Surgeons. https://www.rcseng.ac.uk/standards-and-research/standards-and-guidance/service-standards/emergency-surgery/cholecystectomy-quality-improvement-collaborative/. Accessed March 24, 2019.
9. Gurusamy K, Koti R, Fusai G, Davidson B. Colecistectomía laparoscópica temprana versus tardía para los cólicos biliares no complicados. Cochrane Database of Systematic Reviews. 2013;6(CD007196).
10. Khan SU, Soh JY, Muhibullah N, Peleki A, Abdullah M, Waterland PW. Emergency Laparoscopic Cholecystectomy: Is Dedicated Hot Gall Bladder List Cost Effective?. Journal of Ayub Medical College Abbottabad. 2019 Jan 6;31(1):3-7.
11. Yamashita Y, Takada T, hepato-biliary-pancreatic KH-J of, 2006 undefined. A survey of the timing and approach to the surgical management of patients with acute cholecystitis in Japanese hospitals. Springer. https://link.springer.com/article/10.1007/s00534-005-1088-7. Accessed March 24, 2019.
12. Casillas RA, Yegiyants S, Collins JC. Early laparoscopic cholecystectomy is the preferred management of acute cholecystitis. Archives of surgery. 2008 Jun 16;143(6):533-7.
13. Senapati PS, Bhattarcharya D, Harinath G, Ammori BJ. A survey of the timing and approach to the surgical management of cholelithiasis in patients with acute biliary pancreatitis and acute cholecystitis in the UK. Annals of the Royal College of Surgeons of England. 2003 Sep;85(5):306.
How to Cite
Qaiser M, Rehan M, Siddique K, Anwar M, Khan O, Rehan K. Outcomes of patients presenting with Cholecystitis in terms of Early vs Delayed Cholecystectomy. JRMC [Internet]. 30Sep.2021 [cited 1Oct.2022];25(3):355-9. Available from: https://www.journalrmc.com/index.php/JRMC/article/view/1561