ORIGINAL ARTICLES   

Chirurgia 2011 June;24(3):121-4

Copyright © 2011 EDIZIONI MINERVA MEDICA

language: English

Acute cholecystitis: conservative treatment and delayed cholecystectomy

Kontopodis N., Spiridakis K., Panagiotakis G., Grigoraki M., Kokkinakis T., Rokadakis L.

Surgical Department, Venizeleion General Hospital Heraklion, Heraklion, Crete, Greece

Aim. In our study we examine 315 patients with acute cholecystitis that were initially treated with conservative treatment and after 6-8 weeks underwent delayed elective cholecystectomy and we compare our results with the current bibliography to determine if early or delayed cholecystectomy is the best way to treat patients with acute cholecystitis.
Methods. A total amount of 315 patients with acute cholecystitis were hospitalized in our department during the years 2008 and 2009. The average age of our patients was 51.9 years. Out of 315 patients 209 were women (66.35%) and 106 men (33.65%). All of them underwent initial conservative treatment and delayed cholecystectomy.
Results. Of all 315 patients in 16 (5.07%) conservative treatment considered to have failed after a mean time of 5 days and an urgent open cholecystectomy was performed. A total hospitalization of 9 days was necessary for this group. The rest 299 patients after initial conservative treatment and a hospital stay of 5 days left the hospital and returned after 6-8 weeks to have delayed cholecystectomy. 258 patients (81.9%) underwent laparoscopic cholecystectomy and required 2 more days of hospital stay. 32 patients (10.15%) underwent open cholecystectomy for various reasons and stayed in hospital for 4 days and 9 (2.85%) patients were converted from laparoscopic to open surgery and had 9 days hospitalization. An overall average time of 7.5 days of hospitalization was found.
Conclusion. Conservative treatment and delayed cholecystectomy seems to be a safe approach for the patient with acute cholecystitis resulting in less complications and lower conversion rates without any important increase of total hospital stay, when compared with early cholecystectomy.